Acute appendicitis in pregnancy: Specific features of diagnosis and treatment

Miloudi, N.; Brahem, M.; Abid, S. Ben; Mzoughi, Zeineb; Arfa, Nafaa; Khalfallah, Mohamed Tahar

doi:10.1016/j.jviscsurg.2012.06.003

Cited by 28 publications

(29 citation statements)

References 21 publications

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“…[21,22] Terzi et al found rate of 13% [14] and Miloudi et al reported negative appendectomy rate of 3.4%. [23] Present study finding of 30% rate is higher than literature findings, but may be explained by inability to perform MRI or presence of physical findings that indicated urgent exploration.…”

Section: Discussioncontrasting

confidence: 79%

Acute appendicitis during pregnancy: Case series of 20 pregnant women

Arer

Alemdaroğlu²,

Yeşilağaç³

et al. 2016

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Acute appendicitis (AA) is the most common cause of acute abdomen during pregnancy. Most of the signs of appendicitis are also found during normal pregnancy period, however, and diagnosis of appendicitis during pregnancy remains challenging. The aim of the current study was to report our clinical experience of AA during pregnancy and investigate optimal management of this difficult situation.

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Section: Discussioncontrasting

confidence: 79%

Acute appendicitis during pregnancy: Case series of 20 pregnant women

Arer

Alemdaroğlu²,

Yeşilağaç³

et al. 2016

Ulus Travma Acil Cerrahi Derg

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“…Appendicitis during pregnancy is attended by a significant obstetrical risk, as is demonstrated in this report and in other published series [2]. Thus, the risk of premature labor and delivery and of low-birth weight as well as other obstetrical complications is increased after acute appendicitis.…”

Section: Prognostic Factors Related To Pregnancysupporting

confidence: 75%

“…In a recent literature review [3], complicated appendicitis was more often associated with fetal loss than was simple unperforated appendicitis (12.1% vs. 3.4%, P = 0.0027). Similarly, in the Taiwanese register of appendicitis during pregnancy, patients who had been hospitalized for abdominal pain during the preceding days had an increased risk of premature delivery (30.8% vs. 11%, P = 0.002) and of low birth weight (38.5% vs. 21.9%, P = 0.046) [2]. The diagnosis of appendicitis should always be considered in any pregnant women who presents with acute abdominal pain.…”

Section: Prognostic Factors Related To Pregnancymentioning

confidence: 99%

Appendicitis in the pregnant woman: Be less afraid for the pregnancy than for the consequences of inaction!

Savary

2012

Journal of Visceral Surgery

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EDITORIALAppendicitis in the pregnant woman: Be less afraid for the pregnancy than for the consequences of inaction!The article published in this issue presents a large series of pregnant patients with acute appendicitis [1]. We take this occasion to underline several messages that surgeons as well as radiologists and obstetrician-gynecologists should take to heart in what should be a cooperative multi-disciplinary management strategy.

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“…cute appendicitis is one of the most common indications for abdominal surgery in children, adults, and pregnant women (1)(2)(3)(4)(5). An accurate diagnosis is important to minimize perforation and rates of appendectomy with negative results.…”

mentioning

confidence: 99%

Acute Appendicitis: A Meta-Analysis of the Diagnostic Accuracy of US, CT, and MRI as Second-Line Imaging Tests after an Initial US

Eng¹,

Abadeh

Ligocki³

et al. 2018

Radiology

102

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Purpose To evaluate the sensitivity, specificity, and diagnostic odds ratios of US, CT, and MRI as second-line imaging modalities after initial US for assessing acute appendicitis in children and adults. Materials and Methods A literature search was conducted in Medline and Embase to identify articles that used surgery or histopathologic examination alone or in combination with clinical follow-up or chart review to evaluate the diagnostic accuracy of second-line imaging modalities. The quality of articles was assessed by using the Quality Assessment of Diagnostic Accuracy Studies-2 and the Standards for Reporting of Diagnostic Accuracy tools. Results For studies of children, the number of studies and patients were as follows: US, six studies and 548 patients; CT, nine studies and 1498 patients; MRI, five studies and 287 patients. For studies of adults, the number of studies and patients were as follows: US, three studies and 169 patients; CT, 11 studies and 1027 patients; MRI, six studies and 427 patients. Pooled sensitivities and specificities of second-line US for diagnosis of appendicitis in children were 91.3% (95% confidence interval [CI]: 83.8%, 95.5%) and 95.2% (95% CI: 91.8%, 97.3%), respectively; and in adults, the pooled sensitivities and specificities were 83.1% (95% CI: 70.3%, 91.1%) and 90.9% (95% CI: 59.3%, 98.6%), respectively. Regarding second-line CT in children, the pooled sensitivities and specificities were 96.2% (95% CI: 93.2%, 97.8%) and 94.6% (95% CI: 92.8%, 95.9%); and in adults, the pooled sensitivities and specificities were 89.9% (95% CI: 85.4%, 93.2%) and 93.6% (95% CI: 91.2%, 95.3%), respectively. Regarding second-line MRI in children, pooled sensitivities and specificities were 97.4% (95% CI: 85.8%, 100%) and 97.1% (95% CI: 92.1%, 99.0%); and in adults, the pooled sensitivities and specificities were 89.9% (95% CI: 84.8%, 93.5%) and 93.6% (95% CI: 90.9%, 95.5%), respectively. Conclusion Second-line US, CT, and MRI have comparable and high accuracy in helping to diagnose appendicitis in children and adults, including pregnant women. All three modalities may be valid as second-line imaging in a clinical imaging pathway for diagnosis and management of appendicitis.

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Acute appendicitis in pregnancy: Specific features of diagnosis and treatment

Abstract: Acute appendicitis puts both maternal and fetal prognosis at risk. Management should be prompt and undertaken by a multidisciplinary team approach. Morbidity and mortality are not negligible.

Cited by 28 publications

References 21 publications

Acute appendicitis during pregnancy: Case series of 20 pregnant women

Acute appendicitis during pregnancy: Case series of 20 pregnant women

Appendicitis in the pregnant woman: Be less afraid for the pregnancy than for the consequences of inaction!

Acute Appendicitis: A Meta-Analysis of the Diagnostic Accuracy of US, CT, and MRI as Second-Line Imaging Tests after an Initial US

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