Appendicitis during pregnancy

　　The cause of appendicitis is the obstruction of the appendix lumen and the invasion of bacteria. During the second trimester of pregnancy, the uterus grows larger. The pressure of the uterus on the appendix wall makes the appendix lumen more prone to obstruction. As the cecum appendix moves up with the growth of the uterus, it also causes the appendix to twist, adhere, ischemia, and lumen obstruction, which increases the incidence of appendicitis during the second trimester of pregnancy.

　　The main complication of appendicitis during pregnancy is peritonitis. Peritonitis is a serious disease caused by bacterial infection, chemical irritation, or injury. Patients mainly present with abdominal pain, abdominal muscle tension, nausea, vomiting, fever, and in severe cases, may lead to a decrease in blood pressure and systemic toxic reactions.

　　Early appendicitis during pregnancy is characterized by symptoms such as fever, nausea, vomiting, and lower abdominal pain. Examination may reveal tenderness, rebound pain, and muscle tension in the lower right abdomen. The total white blood cell count is elevated, and the symptoms and signs are similar to those of acute appendicitis in non-pregnant individuals. In the second and third trimesters of pregnancy, acute appendicitis may cause the appendix to shift due to the enlarged uterus, resulting in a higher pain point during examination, with the most severe pain possibly reaching the right lower liver area. Due to the uterus pushing up the abdominal wall peritoneum, the appendix is deep in the abdominal cavity and covered by the enlarged uterus, making the signs of localized peritonitis atypical.

　　In the prevention of this disease, attention should be paid to the following points:

　　1, Keep a regular diet.Overeating and fasting can change the normal peristalsis of the intestines, causing intestinal function to be disordered.

　　2, Maintain optimism.Bad emotions are prone to cause nervous disorders, leading to abnormal gastrointestinal function and triggering appendicitis.

　　3, Adjust cold and heat.Pay attention to changes in seasons and climate. Protect the abdomen from cold stimulation and maintain the normal function of the gastrointestinal tract.

　　4, Prevent constipation and diarrhea.When constipation and diarrhea occur, it is necessary to actively find the cause and adjust and treat in a timely manner.

　　5, Eliminate intestinal parasites.Intestinal parasites such as Ascaris lumbricoides and Enterobius vermicularis can enter the appendix cavity, block the lumen, and induce infection, leading to appendicitis.

　　6, Participate in sports activities appropriately.Participating in physical exercise and labor daily can enhance physical fitness, improve gastrointestinal function, and enhance the body's ability to resist diseases.

　　If the pregnant woman has the following conditions, it can be used as a reference for early diagnosis:

　　1, Sudden abdominal pain occurs after pregnancy, starting from the upper abdominal area or around the umbilicus, followed by lower right abdominal pain.

　　2, The pregnant woman has a history of acute or chronic appendicitis before pregnancy.

　　3, The location of abdominal pain and tenderness is higher than that of the general population.

　　4, If the diagnosis is uncertain, B-ultrasound examination can be performed, with an accuracy rate of up to 90%-96%.

　　5, Increased peripheral blood white blood cell count, elevated body temperature, and rapid heart rate.

　　For patients with appendicitis during pregnancy, it is advisable to maintain a light diet, eat more foods rich in fiber to keep the bowels regular. Generally speaking, meat with warm and hot properties, such as mutton, beef, and dog meat, should be restricted, and scallions, ginger, garlic, and chili should not be eaten in large quantities. Foods with the functions of clearing heat, detoxifying, and promoting diuresis, such as mung beans, sprouts, and bitter melon, can be eaten appropriately in larger quantities.

　　If this disease is found during pregnancy, surgical treatment should be performed. If the appendix has perforated, after the appendix is removed, try to remove the pus as clean as possible, and open the abdomen for drainage. If the pregnant woman needs to continue pregnancy, within 3-4 days after the appendectomy, contraction inhibitors and sedatives can be administered. After surgery, a large amount of antibiotics should be given. After delivery, the uterus shrinks, which can cause the originally localized abscess to spread to the abdominal cavity. At this time, emergency laparotomy and drainage should be performed.