Gebelikte akut apandisit

AMAÇ: Akut apandisit gebelerde non-obstetrik akut karýnýn en sýk nedenidir. Bu çalýþmada, acil servisimize karýn aðrýsý nedeniyle baþvuran ve akut apandisit tanýsý konulan hastalarýmýzý literatür eþliðinde inceledik.
GEREÇ VE YÖNTEM: 2016–2019 yýllarý arasýnda Þanlýurfa Eðitim ve Araþtýrma Hastanesi Acil Servisine baþvuran 17 adet gebe akut apandisit hastasý elektronik kayýt ortamýnda geriye dönük olarak incelendi. Hastalarýmýz yaþ, gebelik haftasý, klinik durumlarý, yapýlan operasyon, ultrasonografi sonuçlarý, patoloji sonuçlarý, ek hastalýk durumlarý, laboratuvar sonuçlarý ve yatýþ süreleri yönünden deðerlendirildi.
BULGULAR: Hastalarýmýzýn yaþ ortalamasý 25.5 (18–41) idi. Baþvuru anýnda 3 hasta birinci trimester (%17.6), 11 hasta ikinci trimester (%64.8), üç hasta da üçüncü trimesterde (%17.6) idi. Hastalarýmýzýn hepsinde karýn aðrýsý þikayeti mevcuttu. Yapýlan ultrasonografi incelemede 11 hastada akut apandisit saptanýrken altý hastada apandisit izlenemedi. Miadý gelen Ýki tanesine apendektomi operasyonuyla eþ olarak sezeryan iþlemi de uygulandý. Hastalarýmýzýn hastanede yatýþ süresi ortalama 2.9 (2–5) idi. Histopatolojik olarak opere olan hastalarýmýzýn 13’ü (%86.7) akut apandisit tanýsý almýþ idi. Ameliyat sonrasý dönemde anne ve bebeklerde ek problem izlenmedi.
TARTIÞMA: Karýn aðrýsý ile acil servise baþvuran gebe hastalarda akut apandisit non-obstetrik bir patoloji olarak göz önünde tutulmalýdýr. Klinik seyir ve fizik muayene bakýmýndan farklýlýklar gösteren bu durum titiz ve multidisipliner bir yaklaþýmla irdelenmesi anne ve bebek saðlýðý açýsýndan önem arz ettiði kanýsýndayýz.

Acute appendicitis in pregnancy

BACKGROUND: Acute appendicitis is the most common cause of non-obstetric acute abdomen in pregnant women. We examined the patients who were admitted to our emergency department with abdominal pain and diagnosed with acute appendicitis in the light of the literature.
METHODS: Seventeen pregnant patients with acute appendicitis who were admitted to the emergency department of Sanliurfa Training and Research Hospital between the years of 2016–2019 were retrospectively analyzed using an electronic recording system. Our patients were evaluated concerning age, gestational week, clinical status, the operation performed, ultrasonography results, pathology results, presence of additional diseases, laboratory results and hospital stay length.
RESULTS: The mean age of our patients was 25.5 (18–41) years. Three patients were in the first trimester (17.6%), 11 patients were in the second trimester (64.8%), and three patients were in the third trimester (17.6%) at the time of admission. All of our patients had abdominal pain. Acute appendicitis was detected in 11 patients, while it was not detected in six patients on the USG examination. Two patients having term delivery underwent caesarean section with concurrent appendectomy. The mean hospital stay length was 2.9 (2–5) days. Histopathologically, 13 (86.7%) of our operated patients were diagnosed with appendicitis. No additional problems were observed in the mothers and infants in the postoperative period.
CONCLUSION: Acute appendicitis should be considered as a non-obstetric pathology in pregnant patients admitted to the emergency department with abdominal pain. We think that it is important for both maternal and infant health to examine this condition, which shows differences concerning clinical course and physical examination, with a meticulous and multidisciplinary approach.