Laparostomy during pregnancy: A case report

Abstract

HighlightsAcute appendicitis is the main indication for surgery during pregnancy.Although pregnancy is not a risk factor for acute appendicitis, appendix rupture is higher amongst pregnant women.During pregnancy, delayed diagnosis is the main factor for poor prognosis as it allows for disease progression.Laparostomy constitutes a damage control gesture,preventing abdominal compartment syndrome and allowing subsequent surgical revision.Principles of the abdominal sepsis and damage control approach are reproducible in the pregnant woman.

Damage Control Laparotomy with Appendectomy and Cesarean Section in the Setting of Perforated Appendicitis

“…The other setting is in major trauma after a laparotomy and stat C-section. However, the use of damage control surgery for primary intra-abdominal pathology in the setting of C-section is rarely reported [20]. There are multiple interesting reports of gastrointestinal perforations during pregnancy, including perforation from appendicitis, with mixed outcomes, but damage control techniques were not employed [21,22].…”

Appendicular Perforation in Pregnancy

“…[1][2][3][4][5] It is estimated that acute appendicitis occurs between 0.06% and 0.28% in pregnancy. 1,6 Acute appendicitis in pregnancy have atypical presentation and often it is lately diagnosed due to inability to use radiation and anatomical changes in location of appendix especially in third trimester. 7,8 The typical patient presentation of right lower quadrant pain, fever, leukocytosis etc.…”