The diagnosis of appendicitis in late pregnancy is difficult, but a ruptured appendiceal abscess presenting with a history of polyhydramnios in early labor can make the diagnosis even more challenging.
A 30-year-old in her third pregnancy with an estimated gestational age [EGA] of thirty weeks was admitted with epigastric pain, headache, and regular uterine contractions. She was initially treated as a case of premature labour and given Dexamethasone. The contractions settled the following day. Forty-eight hours later she developed signs of severe abdominal pain and monitoring showed signs of foetal distress. Ceassarean section was performed and a live female baby was born. The peritoneum was found to be full of free purulent discharge emanating from a perforated appendiceal abscess. Appendectomy was performed followed by peritoneal toilet. The postoperative period was complicated by paralytic ileus and respiratory difficulties due to pilmonary congestion. Complications in the context of appendectomy in pregnancy are discussed with relevance to the current literature
Khalil E. Rajab ,Khalil E. Rajab ,Jonathan H. Skerman ,
Appendicitis in late pregnancy: a case report and review of the literature,
J. Bahrain Med. Soc. 2003;
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