Pregnant patients requiring appendectomy: comparison between open and laparoscopic approaches in NY State
AbstractIntroductionEven though acute appendicitis is the most common general surgical condition encountered during pregnancy, the preferred approach to appendectomy in pregnant patients remains controversial. Current guidelines support laparoscopic appendectomy as the treatment of choice for pregnant women with appendicitis, regardless of trimester. However, recent published data suggests that the laparoscopic approach contributes to higher rates of fetal demise. Our study aims to compare laparoscopic and open appendectomy in pregnancy at a statewide population level.MethodsICD-9 codes were used to extract 1006 pregnant patients undergoing appendectomy between 2005 and 2014 from the NY Statewide Planning and Research Cooperative System (SPARCS) database. Surgical outcomes (any complications, 30-day readmission rate, length of stay (LOS)) and obstetrical outcomes (antepartum hemorrhage, preterm delivery, cesarean section, sepsis, chorioamnionitis) were compared between open and laparoscopic appendectomy. Multivariable generalized linear regression models were used to compare different outcomes between two surgical approaches after adjusting for possible confounders.ResultsThe laparoscopic cohort (n = 547, 54.4%) had significantly shorter LOS than the open group (median ± IQR: 2.00 ± 2.00 days versus 3.00 ± 2.00 days,p value
Publication date: Available online 7 October 2020Source: Annals of Medicine and SurgeryAuthor(s): Nitasha Saleem, Fakhar Shahid, Syed Mohammed Ali, Sameera Rashid, Mohannad Al-Tarakji, Mohammad Sameer
(American College of Surgeons) Pregnant women who underwent immediate surgery to treat a ruptured or abscessed appendix and their fetuses had significantly better outcomes than those whose condition was managed without an operation.
Nonoperative management of appendicitis is increasingly common, however its role in pregnancy is unclear. Appendectomy and appendicitis treated with antibiotics can both increase the risk of adverse obstetric outcomes (AOO). We aim to characterize the use of nonoperative management, patient characteristics, and rates of AOO with either treatment.
This study aimed to compare clinical outcomes for nonoperative and operative management in complicated appendicitis during pregnancy.
CONCLUSION: Considering WBC, NLR, CAR and LCR parameters in addition to medical history, physical examination and imaging techniques could help clinicians diagnose acute appendicitis in pregnant women. PMID: 32946079 [PubMed - as supplied by publisher]
In this study, with the proven advantages of the laparoscopic techniques, LA was found to be safe and feasible for pregnant women during the second trimester.
ConclusionUsing BMI cut-off values for determining the efficaciousness of US visualization of the appendix in pregnant women with suspicion of appendicitis could significantly reduce the non-visualization rate.
Authors: García Roa M, Arias Gómez A, García Franco R, Ramírez Neria P Abstract Endogenous endophthalmitis is a disease that potentially threatens vision. It is produced by the haematogenous spread of microorganisms from a septic focus. It is a rare condition that is related to debilitating diseases, immunosuppression states, and invasive procedures. Endogenous endophthalmitis during pregnancy is even rarer, and has become a challenge due to the safety and side effects of the local and systemic treatments. The case is presented of a pregnant woman with a history of complicated appendicit...
Abstract The risk of venous thromboembolism increases during pregnancy and postpartum. The incidence in the first six weeks following delivery is approximately 0.15%. Deep vein thrombosis may present with acute appendicitis-like symptoms such as right iliac fossa pain, nausea and vomiting. A 22-year-old woman was admitted with complaints of abdominal pain and vomiting 20 days after spontaneous vaginal delivery. Physical examination and radiological findings were compatible with acute appendicitis. Preoperative re-examination and re-evaluation of computed tomography revealed concomitant deep vein thrombosis on the ...
Discussion Peritoneal fluid is normal. It decreases the friction of the peritoneum covering abdominal and pelvic organs and helps to protect them and allow their movement. A normal amount of peritoneal fluid is expected on radiological evaluation. Increased peritoneal fluid is a continuum and is concerning as a wide variety of pathological causes are associated with it such as abdominal trauma and appendicitis. At the far end of the scale is ascites that is the accumulation of free fluid more than 25 ml. It is usually associated with abdominal distension but fluid must accumulate before distension can occur and therefore i...