Apendicectomía en la embarazada: Experiencia en un hospital público chileno

Background: Acute appendicitis is the most common non obstetric surgical emergency during pregnancy. Aim: To asses our experience in the diagnosis and management of acute appendicitis occurring during pregnancy. Patients and methods: Data from all pregnant patients who were subjected to an appendect...

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Autores principales: Butte B,Jean Michel, Bellolio A,M Fernanda, Fernández L,Francisca, Sanhueza G,Marcel, Báez V,Sergio, Kusanovich B,Rodrigo, Viñuela F,Eduardo, González P,Rogelio, Pruyas A,Martha, Díaz A,Verónica, Martínez C,Jorge
Lenguaje:Spanish / Castilian
Publicado: Sociedad Médica de Santiago 2006
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Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000200002
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Sumario:Background: Acute appendicitis is the most common non obstetric surgical emergency during pregnancy. Aim: To asses our experience in the diagnosis and management of acute appendicitis occurring during pregnancy. Patients and methods: Data from all pregnant patients who were subjected to an appendectomy for a suspected acute appendicitis from January 1998 to December 2002, were retrospectively analyzed. All pathological, surgical, clinical records and the delivery outcome registry of each patient were reviewed. Results: Among 47,322 deliveries, 46 pregnant women aged 29±9 years and with a gestational age of 21±7 weeks, were operated because of a presumptive acute appendicitis. Forty (87%) had a histopathologically proven appendicitis; ten (25%) cases had a perforated appendix and 30 (75%) had a non-perforated appendicitis. Five (10.9%) patients had a negative laparotomy and one had a necrotic ovarian tumor. Patients with perforated and non perforated appendices had a similar lapse from the onset of symptoms to operation (69±45 and 50±34 hours respectively, NS) and a similar white cell count (15,667±3,707 and 13,006±5,206 cells/mm³, respectively, NS). Wound infection was the most common surgical complication in 15%. Seven (15%) patients had a premature delivery and there was one fetal death (2.2%). There were no pregnancy complications on negative appendectomy cases. Conclusions: Acute appendicitis continues to be a challenge in diagnosis and treatment during pregnancy. Maternal and fetal outcome was better than previously reported