Pregnancy complicated by acute appendicitis

　　Pregnancy complicated by acute appendicitis is caused by the obstruction of the appendiceal lumen and the invasion of bacteria or the acute onset of chronic appendicitis. The increased pressure on the appendiceal lumen wall by the enlarged uterus in the second trimester makes the lumen more prone to obstruction. The ascending position of the cecum and appendix with the enlargement of the uterus also causes twisting, adhesion, ischemia, and lumen obstruction of the appendix, resulting in a relatively increased incidence of appendicitis in the second trimester of pregnancy.

　　Pregnancy complicated by appendicitis is more prone to appendiceal perforation due to its specificity. If the inflammation spreads, it can cause diffuse peritonitis, leading to serious consequences such as sepsis, paralytic ileus, portal vein inflammation, and multiple liver abscesses, posing great danger to the lives of both the mother and the child. If the periappendiceal abscess is not drained in time, it can break through to the intestines, bladder, or abdominal wall, forming various internal or external fistulas. Infectious thrombi in the appendiceal veins can extend along the superior mesenteric vein to the portal vein, causing portal vein inflammation, which can further lead to liver abscess.

　　Patients with pregnancy complicated by acute appendicitis usually may have the following symptoms:

　　1. Abdominal pain

　　The inherent regularity of转移性腹痛in most cases of acute appendicitis during pregnancy remains unchanged, and abdominal pain often starts from below the sternum, extending to the umbilical area, and then transferring to the lower right abdomen after several hours or ten or more hours. Some patients have atypical symptoms. In the early stages of pregnancy, the symptoms of appendicitis are similar to those during non-pregnancy. In the middle and late stages of pregnancy, due to the enlargement of the pregnant uterus, the position of the appendix changes, and the pain location of pregnant women can reach the right lower liver area or the right posterior lumbar area, and the pain may be lighter than during non-pregnancy.

　　2. Other symptoms

　　Other symptoms may include nausea, vomiting, diarrhea, and some patients may have fever, malaise, or fatigue.

　　To prevent the occurrence of acute appendicitis during pregnancy, avoid sudden running after meals, and avoid excessive coldness during the hot summer, especially not to drink too much ice beer and other cold drinks. Pay attention to not eating too greasy in daily life, avoid eating too many刺激性 foods, and actively participate in physical exercise to enhance physical fitness and improve immunity. If there is a history of chronic appendicitis, it is even more important to avoid recurrence.

　　Acute appendicitis during pregnancy can be examined according to the examination of appendicitis, and the common examination items are as follows:

　　1. Urinalysis;

　　2. Laparoscopy;

　　3. Bimanual examination;

　　4. Abdominal mass;

　　5. CT examination.

　　There are no special dietary requirements for patients with acute appendicitis during pregnancy after surgery, generally normal diet is sufficient. Pay attention to a rich diet, balanced nutrition. Ensure the need for calories, proteins, and vitamins required for normal human metabolism. Increase the intake of vegetables and fruits appropriately. In terms of health care, it is important to relax the mind, build confidence, maintain a good mental state, and actively cooperate with the doctor's treatment..

　　If acute appendicitis during pregnancy is diagnosed, immediate surgery should be performed. Given that the diagnosis of acute appendicitis during pregnancy is more difficult than during non-pregnancy, a missed diagnosis can lead to perforation and peritonitis, which will significantly increase the mortality rate of both mother and child. Therefore, regardless of any stage of pregnancy, if there is a high suspicion of appendicitis, the indication for laparotomy should be relaxed, and a certain proportion of negative laparotomies is permissible.