Diagnosis of appendicitis in pregnancy.
BACKGROUND
The diagnosis of appendicitis in pregnant patients is challenging.


METHODS
The records of pregnant patients with suspected appendicitis were reviewed.


RESULTS
Forty-seven patients with suspected appendicitis were identified. Twenty-four patients did not undergo surgery. Twenty-three patients had ultrasound (US), none of which visualized the appendix. Seventeen patients were followed up clinically and improved. Six patients had a negative computed tomography (CT) and none required surgery. Twenty-three patients underwent surgery for presumed appendicitis. Three patients had no imaging. Twelve patients had US only; US was positive in 5 patients and all had appendicitis. Seven patients who underwent surgery had a nondiagnostic US. One patient had appendicitis. Seven patients had a positive CT and appendicitis at surgery. One patient had a positive US and magnetic resonance imaging, and had appendicitis. A total of 43 patients had US, of which 86% were nondiagnostic. Six US were read as positive and all patients had appendicitis. Thirteen patients had CT with no false-positive or false-negative results.


CONCLUSIONS
US, when read as positive, requires no further confirmatory test other than surgery. If US is nondiagnostic, further imaging may avoid a negative appendectomy.
Freeland
Michael
M
Department of Surgery, Orlando Regional Medical Center, 86 W. Underwood, Orlando, FL 32806, USA.
King
Erin
E
Safcsak
Karen
K
Durham
Rodney
R
D000328:Adult; D001064:Appendicitis / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000628:therapy