Nonobstetric emergencies in pregnancy: Trauma and surgical conditions

Coleman, Mathew; Trianfo, Victor A.; Rund, Douglas A.

doi:10.1016/s0002-9378(97)70135-2

Cited by 86 publications

(43 citation statements)

References 27 publications

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“…Nonobstetrical/nongynecological conditions include gastroenteritis, urinary tract infections, pyleonephritis, cholecystitis, cholelithiasis, pancreatitis, nephrolithiasis, hernia, bowel obstruction, carcinoma of the large bowel, mesenteric adenitis, and rectus hematoma, pulmonary embolism, right-lower-lobe pneumonia, and sickle cell disease. 18,19 Gynecologic and obstetric conditions include ovarian cyst, adnexal torsion, salpingitis, abruptio placenta, chorioamnionitis, degenerative fibroid, ectopic pregnancy, preeclampsia, round ligament syndrome, and preterm labor. 18,19 One study demonstrated that appendicitis occurred in approximately half of their sample; ovarian cysts, mesenteric adenitis, fibromyoma uteri, varicose veins in the parametria, ileus, salpingitis, and torsion were the other pathologies identified.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…18,19 Gynecologic and obstetric conditions include ovarian cyst, adnexal torsion, salpingitis, abruptio placenta, chorioamnionitis, degenerative fibroid, ectopic pregnancy, preeclampsia, round ligament syndrome, and preterm labor. 18,19 One study demonstrated that appendicitis occurred in approximately half of their sample; ovarian cysts, mesenteric adenitis, fibromyoma uteri, varicose veins in the parametria, ileus, salpingitis, and torsion were the other pathologies identified. …”

Section: Differential Diagnosismentioning

confidence: 99%

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Appendicitis in Pregnancy

Pastore

Loomis²,

Sauret³

2006

The Journal of the American Board of Family Medicine

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Background: Our urban practice had two incidences of documented appendicitis in pregnancy in a 24-hour period with two unique outcomes that prompted an inquiry. Appendicitis in pregnancy is relatively rare, but it has significant morbidity and is a cause of maternal and infant mortality. Abdominal pain is the most common presenting symptom, and the consideration of multiple pathologic disorders should be entertained. Accurate diagnosis of appendicitis in pregnancy is the largest challenge since the signs and symptoms may vary depending on the trimester in which the patient presents.Methods: We undertook a systematic review of English-language articles from 1975 to 2005 using the key words "appendicitis," and "pregnancy" using MEDLINE, CINAHL, and Cochrane Controlled Trials Register databases.Results and

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Section: Differential Diagnosismentioning

confidence: 99%

Section: Differential Diagnosismentioning

confidence: 99%

Appendicitis in Pregnancy

Pastore

Loomis²,

Sauret³

2006

The Journal of the American Board of Family Medicine

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“…Bowel obstruction is the third most common cause of acute abdomen in pregnancy [1]. Adhesions, volvulus and intussusceptions are the major causes of intestinal obstructions in pregnancy [2].…”

Section: Discussionmentioning

confidence: 99%

Small Intestine Ischaemia Due to Volvulus During Pregnancy

Keishing

et al. 2014

JCDR

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Small intestine ischaemia caused by volvulus is difficult to diagnose during pregnancy, as the signs and symptoms may be masked by pregnancy. An early diagnosis and a prompt surgical intervention is necessary, as morbidity and mortality of this disorder are significant. We are presenting a case of a 35-year-old pregnant woman with volvulus of small bowel. CASe RepoRTA 35-year-old woman who was in 32 nd week of gestation, presented to our Emergency Department with severe abdominal pain and nausea. The chief complaint was periumbilical pain of 2 days duration, which was of colicky in nature, which spread to the whole of the abdomen. She also reported of constipation for 1 day and she vomited semisolid particles twice after her admission. On admission, her vitals were found to be not stable and her blood pressure was not recordable. On clinical examination, her abdomen was found to be diffusely tender, with a 32 week gravid uterus and no foetal activity, which were confirmed on doing an emergency ultrasound screening.Laboratory investigations revealed increased blood urea nitrogen and creatinine levels. Patient was stabilized after giving adequate fluid and electrolyte therapy. An emergency laparotomy was done by making a midline incision. 200-300 ml of blood and clot were evacuated. A stillborn foetus was delivered .The death of the foetus was related to toxicity caused by volvulus and foetus was fresh dead at the time of surgery [Table/ Fig-1]. A small intestine volvulus in anti clockwise direction, 60 cm from the Treitz ligament, which spared 10 cm of the terminal ileum, was seen. The bowel was dark and oedematous, which indicated gangrene [Table /Fig-2,3]. Resection of the gangrenous bowel and end to end jejunoileal anastomosis were done. The post-operative period was uneventful. The patient has been followed up in our Outpatients Department for the past [ DiSCuSSionA surgically acute abdomen in pregnancy must be diagnosed early and accurately, as a prompt treatment is necessary, to prevent morbidity and mortality of the patient. It is difficult to diagnose an acute surgical abdomen in pregnancy, due to the increasing size of the uterus and the subsequent dislocations of the intra abdominal organs, high prevalence of hyperemesis gravidarum and abdominal pain in the normal obstetric population, lack of basic facilities for

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“…[2,7] Fetal mortality is given as 5% after appendicitis, whereas this rate increases to approximately 20% in a Management of acute appendicitis in pregnancy perforated appendicitis. Similarly, maternal mortality also increases in perforated cases.…”

Section: Discussionmentioning

confidence: 99%