Diagnosis and Surgical Management of Septic Shock Due to Acute Appendicitis in A Pregnant Woman

Abstract

Introduction: Acute appendicitis is the most frequent non-obstetric surgical complication during pregnancy (25%), and it generally occurs in the second trimester of pregnancy.
Objective: To discuss the basic maneuvers for the diagnostic and surgical management of this pathology in pregnant women.
Case report: We report the case of a 31-year-old pregnant woman, with 33 weeks of amenorrhea, who was operated on for acute appendicitis and had torpid postoperative period, after previous diagnosis of complicated cholecystitis. She was assited at Virgen Macarena University Hospital in Seville, Spain.
Conclusions: The anatomical and physiological changes that pregnancy entails make clinical and radiological diagnosis difficult. A prompt and accurate diagnosis is essential, as perforated appendicitis is associated with high rates of preterm delivery, miscarriage, and fetal loss. Surgical management should not take more than 24 hours from diagnosis, and in the absence of solid
evidence, laparoscopic or laparotomy approaches are safe and reasonable options.