Laparoscopic Appendectomy in the Third Trimester Pregnancy: Approach Challenge

Ramos C*, Samúdio MJ, Santos V, Pereira T, Ferreira C and Miranda L

Department of General Surgery, Centro Hospitalar Universitário Lisboa Norte, Portugal

^*Correspondance to: Carlota Ramos 

 PDF  Full Text DOI: 10.25107/2474-1647.3623

Abstract

Introduction: Acute appendicitis is the most common non-obstetric surgical emergency during pregnancy. Symptoms of acute appendicitis during pregnancy are usually the same as for other patients, however, due the physiologic and anatomic changes throughout pregnancy, the diagnosis may be challenging. In the presence of a high clinical suspicion and no clear results on imaging exams, laparoscopic exploratory surgery can be an option. Case Report: We present the case of a 35-year-old woman with 31 weeks of pregnancy, admitted in the emergency department with a history of right lower quadrant abdominal pain, leukocytosis and increased CRP. An US was made and suggested the diagnosis of appendicitis. Thus, a laparoscopic appendectomy, with left lateral decubitus, was performed. The surgery and postoperative period had no complications, both for the mother and the fetus. Conclusion: Accurate and timely diagnosis and prompt treatment, decrease maternal and fetal morbidity and mortality. There is no place for conservative approach. More recent literature suggests that, with some precautions, and technical expertise/experience, laparoscopy can be performed without complications in all three trimesters, with the same benefits of minimally invasive surgery.

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Cite the article

Ramos C, Samúdio MJ, Santos V, Pereira T, Ferreira C, Miranda L. Laparoscopic Appendectomy in the Third Trimester Pregnancy: Approach Challenge. Clin Surg. 2023; 8: 3623.