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Appendectomy during the third trimester of pregnancy in a 27-year old patient: case report of a "near miss" complication

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Published in Patient Safety in Surgery. 2011, vol. 5, no. 1, p. 11
Abstract The management of acute appendicitis during pregnancy is not fully established, especially regarding the choice between open and laparoscopic surgery during the third trimester. We report herein the case of a major uterine variecele hemorrhage during a laparoscopic appendectomy in a 27-year old pregnant patient at 33 weeks of amenorrhea. After conversion to a Pfannenstiel incision, the baby was delivered, the bleeding stopped and the appendectomy completed. While both mother and child fully recovered, this «near miss» complication underlines the challenges linked to the management of acute appendicitis during pregnancy. Based on a literature review, we propose an algorithm favoring the laparoscopic approach during the first and second trimesters, and the open approach during the third trimester (especially after the 26th week of amenorrhea). In case of unclear pre-operative diagnosis, a laparoscopy should be conducted even during the third trimester with a Mc Burney conversion when the diagnosis of appendicitis is confirmed.
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PMID: 21575272
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Article (Published version) (265 Kb) - public document Free access
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Research groups Chirurgie viscérale (104)
Transplantation et hépatologie (905)
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HOLZER, Thomas et al. Appendectomy during the third trimester of pregnancy in a 27-year old patient: case report of a "near miss" complication. In: Patient Safety in Surgery, 2011, vol. 5, n° 1, p. 11. https://archive-ouverte.unige.ch/unige:24960

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Deposited on : 2013-01-04

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