Outcomes of the patients diagnosed incidentally appendicitis during cesarean section

Abstract

Objectives: Appendicitis is the most common condition leading to an intraabdominal operation for a non obstetric problem in pregnancy and diagnosis of appendicitis is complicated by the physiologic and anatomic changes that occur during pregnancy. Although a surgical procedure carries the risk of fetal loss or preterm delivery, delay in diagnosis also increases the risk of complications in both mother and fetus. In this report we present our experience and analyze clinical characteristic and the pregnancy outcomes of appendicitis diagnosed incidentally during cesarean in the third trimester. Material and methods:The study population consisted of 23 pregnant women who were diagnosed incidentally with appendicitis during cesarean at Erzincan University Hospital between 2015 and 2016.Results: Appendectomy was performed on 23 patients during a caesarean section performed for any reason. The mean diameter of appendix was 7.82 ± 1.85 mm. The mean operation time was 67.39 ± 18.94 SD and antibiotic therapy was given to all patients. Postoperative complications were noted in 4 (17.4%) patients. Wound infection was seen in 4 (17.4%) patients, the other 19 patients revealed no postoperative complications. The mean of APGAR score of newborns in the postoperative period was 8.26 ± 0.86 SD and no complications were observed in both mothers and newborns. Histopathology of the specimen confirmed acute appendicitis in 23 (100%) cases. Conclusions:Acute appendicitis is a challenging diagnosis in the pregnant patient; however, early surgical intervention should be performed with any suspicion. The type of surgery depends on the surgeon's preference and experience.

Variations and morphometric features of the vermiform appendix: A systematic review and meta‐analysis of 114,080 subjects with clinical implications

“…The lack of standardization in naming VA positions, the use of different names for the same locations, and unclear definitions resulted in inconclusive findings about the most frequent location of the VA. Some anatomical and surgical studies employed the categorization method proposed by Wakeley in 1933(Wakeley 1933); however, their own new modifications often fostered even more confusion (Ojeifo et al 1989;Dronov et al 1994;Bakheit and Warille 1999;Jan et al 2005;Ndoye et al 2005;Thyagaraj 2005;Caravaggio et al 2007;Iqbal et al 2011;Turkoglu et al 2012;Patel et al 2013;Sinha 2013;Zachariah 2013;Casado Méndez et al 2014;Lee et al 2014;Mwachaka et al 2014;Yaqoob et al 2014;Kondo et al 2015;Kumar and Hai 2015;_ Inal et al 2016;Kulhan et al 2017;Sinha et al 2017;Aneiros Castro et al 2018). Consequently, due to all these obstacles, data derived from different studies was difficult to compare.…”

Analysis of 190 Female Patients after Appendectomy

“…Prolonged exposure to anesthesia can have an adverse effect. The mean operating time of LA is 45 minutes (range: 10–70 minutes) [ 17 , 18 , 27 , 32 , 35 , 36 ]. In our data, the average time did not differ in the two groups, with a mean of 50 minutes.…”

“…The laparoscopic approach had decreased prevalence of wound infection when compared to open [ 37 , 38 ]. Wound infection occurs in 15% of the patients who underwent appendectomy during cesarean section [ 10 , 13 , 28 , 36 ].…”

Postpartum Acute Appendicitis

“…The typical presentation of acute appendicitis is abdominal pain that initially starts periumbilical and then migrates to the right lower quadrant as the inflammatory process progresses. Fever and leukocytosis may develop later (5,6). However, acute appendicitis is a histological diagnosis and should be strengthened with laboratory and radiologic examinations.…”

“…However, acute appendicitis is a histological diagnosis and should be strengthened with laboratory and radiologic examinations. Ultrasonography, magnetic resonance imaging, and CT are preferred imaging modalities (5,6,7).…”