Revisiting MRI for Appendix Location During Pregnancy

Abstract

The gradual upward displacement of the appendix during pregnancy was confirmed. MRI can be used for determination of the appendix localization in pregnant patients. Further studies with a larger number of patients will be helpful to answer this clinically relevant question.

Computed tomography in adults with atypical clinical presentation of acute appendicitis: comparison of findings with inflammatory serum markers

“…Second, abdominal pain in elderly patients may be minimal and fever may not occur (5/29 cases in our study) [28]. Finally, the diagnosis of AA in pregnant women is difficult because of upward displacement of the cecum and a position of the appendix in the right subcostal area [29].…”

Acute appendicitis in pregnancy

“…Pregnant women are less likely to have a classic presentation of appendicitis than nonpregnant women. The most common symptom of appendicitis, ie, right lower quadrant pain, occurs close to McBurney's point in the majority of pregnant women, regardless of the stage of pregnancy 12,13 ; however, the location of the appendix migrates a few centimeters cephalad with the enlarging uterus, so in the third trimester, pain may localize to the mid or even the upper right side of the abdomen 14,15 . The diagnosis of appendicitis in nonpregnant patients can be difficult, with an accepted false-positive rate of ~15%.…”

Missed Appendicitis in Primary Care: Lessons Learned

“…Acute appendicitis is common during pregnancy with an incidence of 0.15-2.1 per 1,000 pregnancies. Early use of either magnetic resonance imaging (MRI) or abdominal ultrasound (US) will increase diagnostic accuracy of acute appendicitis in pregnancy and prevent both maternal (1-4%) and fetal (1.5-35%) mortality associated with perforation, which may occur more mostly in the third trimester [53][54][55][56][57][58][59][60][61]. Missed appendicitis in pregnancy is common in primary care because of unusual presentation (e.g.…”