Purulent Appendicular Peritonitis in Pregnancy: Management and Pregnancy Outcome

Authored by Piazze Juan

Appendicitis represents the most common cause of acute abdomen in pregnancy, but diagnosis remains challenging.

Case presentation: A 40-years woman at 23 weeks of pregnancy with an under-head presentation of purulent peritonitis secondary to acute appendicitis, we present this case report in order to describe the uneventful maternal-neonatal outcome at term, despite the risky acute abdomen caused by a retrocecal appendicitis at mid pregnancy. Appendicitis represents the most common cause of acute abdomen in pregnancy, accounting for 25% of non-obstetric surgery in pregnant women, with an incidence between 0.06% and 0.28% [1,2]. Forty per cent of cases takes place on the second trimester [3]. Diagnosis of appendicitis during pregnancy remains challenging, for the low sensitivity of ultrasound (US) and low predict value of typical symptoms, due to the change of appendix location and to the physiological mild leukocytosis [4-7]. Therefore, complications occur more frequently during pregnancy than in non-pregnant women [8].

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