Journal of the Chinese Medical Association
Volume 70, Issue 8 , Pages 345-347, August 2007

Magnetic Resonance Imaging as a Diagnostic Tool in Pregnancy with Appendiceal Abscess

  • Ming-Jie Yang

      Affiliations

    • Corresponding Author InformationCorrespondence to: Dr Ming-Jie Yang, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.
  • ,
  • Jen-Yu Tseng
  • ,
  • Wei-Lun Hsu

Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 8 August 2006; accepted 13 June 2007.

Article Outline

Abdominal pain presenting itself during pregnancy may be multifactorial, requiring immediate attention and care. In cases of intractable pain without obstetrical condition, surgical abdominal exploration is widely advised. However, we present a case where a 30-year-old, gravida 1, para 0, female complained of persistent right abdominal pain during her 25th week of pregnancy. Ultrasound revealed a right upper quadrant cystic mass and magnetic resonance imaging was arranged with compatible findings. Final impression of appendiceal abscess was determined. Broad-spectrum antibiotics were administered and the patient was discharged in stable condition after 10 days of conservative treatment. She delivered a healthy baby boy at her 40th week of gestation uneventfully.

Key words:  acute appendicitis , appendiceal abscess , MRI , pregnancy , ultrasonography

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Tracey M , Fletcher HS . Appendicitis in pregnancy . Am Surg . 2000;66:555–560
  2. Mourad J , Elliott JP , Erickson L , Lisboa L . Appendicitis in pregnancy: new information that contradicts long-held clinical beliefs . Am J Obstet Gynecol . 2000;182:1027–1029
  3. Eryilmaz R , Sahin M , Bas G , Alimoglu O , Kaya B . Acute appendicitis during pregnancy . Digest Surg . 2002;19:40–44
  4. Ueberrueck T , Koch A , Meyer L , Hinkel M , Gastinger I . Ninety-four appendectomies for suspected acute appendicitis during pregnancy . World J Surg . 2004;28:508–511
  5. Cunningham FG , McCubbin JH . Appendicitis complicating pregnancy . Obstet Gynecol . 1975;45:415–420
  6. Hsia CY , Chiu JH , Lui WY . Elective interval laparoscopic management for periappendiceal abscess . J Chin Med Assoc . 1995;56:52–57
  7. Andersen B , Nielsen TF . Appendicitis in pregnancy: diagnosis, management and complications . Acta Obstet Gynecol Scand . 1999;78:758–762
  8. Cohen-Kerem R , Railton C , Oren D , Lishner M , Koren G . Pregnancy outcome following non-obstetric surgical intervention . Am J Surg . 2005;190:467–473
  9. Gomez A , Wood M . Acute appendicitis during pregnancy . Am J Surg . 1979;137:180–183
  10. Thompson JD , Warshaw JS . The vermiform appendix in relation to gynecology . In:  Rock JA ,  Thompson JD editor. TeLinde's Operative Gynecology . 8th edition. Philadelphia: Lippincott-Raven; 1997;
  11. Maslovitz S , Gutman G , Lessing JB , Kupfeminc MJ . The significance of clinical signs and blood indices for the diagnosis of appendicitis during pregnancy . Gynecol Obstet Invest . 2003;56:188–191
  12. Babaknia A , Parsa H , Woodruff JD . Appendicitis during pregnancy . Obstet Gynecol . 1977;50:40–44
  13. Hodjati H , Kazerooni T . Location of the appendix in the gravid patient: a re-evaluation of the established concept . Int J Gynaecol Obstet . 2003;81:245–247
  14. Hsia HC , Shoung LK , Chen ML , Wong DW . Acute pancreatitis complicated with periappendicitis . J Chin Med Assoc . 2002;65:619–621
  15. Lim HK , Bae SH , Seo GS . Diagnosis of acute appendicitis in pregnant women: value of sonography . AJR Am J Roentgenol . 1992;159:539–542
  16. Puylaert JB . Acute appendicitis: US evaluation using graded compression . Radiology . 1986;158:355–360
  17. Pedrosa I , Levine D , Eyvazzadeh AD , Siewert B , Ngo L , Rofsky NM . MR imaging evaluation of acute appendicitis in pregnancy . Radiology . 2006;238:891–899
  18. Cobben LP , Groot I , Haans L , Bickman JG , Puylaert J . MRI for clinically suspected appendicitis during pregnancy . AJR Am J Roentgenol . 2004;183:671–675
  19. Horowitz MD , Gomez GA , Antiesteban R , Burkett G . Acute appendicitis during pregnancy . Arch Surg . 1985;120:1362–1367
  20. Ackerman NB . The continuing problems of perforated appendicitis . Surg Gynecol Obstet . 1974;139:29–32
  21. Halvorsen AC , Brandt B , Andreasen JJ . Pregnancy complicated by acute appendicitis: commentary . Acta Obstet Gynecol Scand . 1991;70:183–184
  22. Tamir IL , Bongard FS , Klein SR . Acute appendicitis in the pregnant patient . Am J Surg . 1990;160:571–576
  23. Bradley EL , Isaacs J . Appendiceal abscess revisited . Arch Surg . 1978;113:130–132
  24. Skoubo-Kristensen E , Hvid I . The appendiceal mass: results of conservative management . Ann Surg . 1982;196:584–587

PII: S1726-4901(08)70016-9

doi:10.1016/S1726-4901(08)70016-9

Journal of the Chinese Medical Association
Volume 70, Issue 8 , Pages 345-347, August 2007