AppendicitisDuringPregnancy
Appendicitis During Pregnancy
EpidemiologyAnatomicalchangesPathophysiologyComplicationsDiagnosisODDSurgeryConclusion
❑Epidemiology ❑Anatomical changes ❑Pathophysiology ❑Complications ❑Diagnosis ❑DD ❑Surgery ❑Conclusion
EpidemiologyLifetime occurrence of 7%Peak incidence: 10-30yThe most common cause of acute abdomen inpregnancy non-obstetric surgical interventionduring pregnancy {Accounts for 25%)Suspected in:1in1000pregnantwomen(MazzeandKallen,1991)Confirmedin:65%
Epidemiology ✓ Lifetime occurrence of 7% Peak incidence: 10-30y ✓ The most common cause of acute abdomen in pregnancy non-obstetric surgical intervention during pregnancy {Accounts for 25%} ✓ Suspected in: 1 in 1000 pregnant women (Mazze and Källén, 1991) Confirmed in: 65%
Incidence:1in1500pregnanciesReduced during pregnancy, especially in 3rd T(Protective effect of pregnancy?](Andersson &Lambe,2001)Same (Some studies)·Equal in all three trimesters: 1st T: 30% 2nd T: 45% 3rd: 25%
❑ Incidence: 1 in 1500 pregnancies Reduced during pregnancy, especially in 3rd T {Protective effect of pregnancy?} (Andersson &Lambe, 2001). Same (Some studies) • Equal in all three trimesters. • 1 st T: 30% • 2 nd T: 45% • 3 rd: 25%
AnatomicalchangesduringpregnancyI. Position of appendix:Gravid uterus →displacement upward &outward(Baeretal,1932,manyauthors)No change in location (Mourad et al, 2000; Hodjatiet al,2003)Degree of displacement, if any, is likely due todifferingextentofcecalfixation
Anatomical changes during pregnancy I. Position of appendix: Gravid uterus → displacement upward & outward (Baer et al, 1932, many authors) No change in location (Mourad et al, 2000; Hodjati et al ,2003) Degree of displacement, if any, is likely due to differing extent of cecal fixation