Acute Appendicitis in Late Pregnancy

Parker, R.B.

doi:10.1016/s0140-6736(54)92769-5

Cited by 16 publications

(3 citation statements)

References 12 publications

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“…nausea, vomiting, loss of appetite and abdominal discomfort [1,6,13,[17][18][19]. Furthermore, the displacement of the appendix from the second trimester of pregnancy renders localization of referred pain from the inflamed organ a difficult task by means of physical examination.…”

Section: Discussionmentioning

confidence: 99%

The Significance of Clinical Signs and Blood Indices for the Diagnosis of Appendicitis during Pregnancy

Maslovitz

Gutman

Lessing

et al. 2003

Gynecol Obstet Invest

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Objective: To evaluate the significance of clinical signs and blood indices for the diagnosis of appendicitis during pregnancy. Sample: Of the 40,112 women delivering at our institution (January 1995 to June 2002), 38 women (0.094%) were operated due to the suspicion of appendicitis during pregnancy. Methods: Body temperature, clinical examination, white blood cell counts and lag time from arrival to operation were obtained for each patient. All women were operated with the clinical diagnosis of appendicitis, and their appendices were removed and examined by a pathologist. Results: Inflammatory appendix was discovered in 19 (0.047%) of the pregnancies with subsequent deliveries while a normal appendix was found in 19 of the 38 (50%) appendices removed. The group with normal appendix did not significantly differ from women with inflamed appendix with regard to gestational age at presentation, signs of peritoneal irritation, body temperature, leukocyte count, time elapsed between arrival and surgery, gestational age at delivery and birth weight. Conclusions: The accurate diagnosis of appendicitis during pregnancy is a difficult task requiring a very high level of suspicion and clinical skills and not merely relying upon laboratory and classic signs.

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Section: Discussionmentioning

confidence: 99%

The Significance of Clinical Signs and Blood Indices for the Diagnosis of Appendicitis during Pregnancy

Maslovitz

Gutman

Lessing

et al. 2003

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…As the appendix is displaced upwards by the enlarging uterus, and may even lie behind it as a "retro-uterine appendix" (Leslie, 1966), the classical shift of the site of the pain from diffuse central to the right lower quadrant becomes less common as pregnancy advances. Parker (1954), for example, found such a shift in only 2 of 6 cases in the last trimester. Lake (1956) reviewed 55 cases throughout the whole of pregnancy, and noted a shift of pain in 25%, becoming less common near term.…”

Section: -Imentioning

confidence: 91%

“…Has Caesarean section any other place in patients with appendicitis in late pregnancy? Most writers (Parker, 1954;Merscheimer and Wattiker, 1960) state that except for access, Caesarean section should not be performed, even where the appendix has perforated, since there is no evidence that subsequent labour will disseminate the infection through the peritoneal cavity. Pfleiderer (1963) is also of this opinion.…”

Section: Treatmentmentioning

confidence: 99%