阑尾炎与妊娠21例报道(法)

作     者：Lebeau R. DianéB. Koffi E. 朱亮 

作者机构：Service de Chirurgie Gérale et Digestive CHU de Bouaké BP 139 Abidjan 22 Cote d'Ivoire 

出 版 物：《世界核心医学期刊文摘（妇产科学分册）》 (Core Journal in Obstetrics/Gynecology)

年 卷 期：2006年第2卷第3期

页      面：60-61页

学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学] 

主　　题：急性阑尾炎 妊娠晚期 阑尾切除术 弥漫性腹膜炎 超声图 腹腔镜下手术 腹部超声检查 治疗特点 协助诊 

摘      要：Objective. Describe the epidemiological, diagnostic and therapeutic features of acute appendicitis in pregnant women. Material and methods. Retrospective analysis of a series of 21 cases of appendicitis in pregnant women who underwent surgery between January 1997 and June 2001. Results. The association of acute appendicitis with pregnancy was noted in 0.2%of the pregnant women. Ten patients were in the first trimester of pregnancy, ten in the second and one in the third. Abdominal pain was noted in all patients. The localization varied with gestational age. Abdominal ultrasound contributed to the diagnosis in twenty patients who underwent the examination. Diagnoses retained were: acute uncomplicated appendicitis (n=18), acute appendicitis with focal induration (n=1) and acute diffuse peritonitis (n=2). Appendectomy was performed in all cases. Intensive care, peritoneal cleaning and drainage were associated in cases with appendicitis. In cases with focal induration, medical treatment was followed by appendectomy performed after delivery. Tocolysis was instituted in all cases. Twelve pregnancies continued to delivery: one fetal death, one premature delivery and ten term deliveries of live infants. Conclusion. Pregnancy makes it difficult to confirm the diagnosis of appendicitis. Appendectomy should be performed in patients presenting a highly suggestive clinical and ultrasonographic picture, preferably by laparoscopy in order to avoid more severe complications which could be life-threaten-ing for the mother or infant.