| Discussion in 'All Categories' started by Dr G Phanipriya - Jan 11th, 2012 1:29 am. | |
Dr G Phanipriya
|
I had a 25yr old lady 9weeks pregnant with h/o sudden onset severe right lower quadrant pain associated with vomiting. O/E - She was afebrile. P-90/min, PA-Severe tenderness & rebound tenderness in RIF. Clinical diagnosis was Acute Appendicitis. TLC-13800, n-87%, CRP-24, USG-Unremarkable. She was managed conservatively for 24 hrs with IV antibiotics & analgesics with no relief of pain. She was taken up for Laparoscopic Appendicectomy. Intra-operatively, there was a twisted right adnexal mass over a fibrous band in the pelvis causing bluish-black discoloration (pre-gangrenous). The appendix looked grossly normal. After the adnexal mass was unwound, the colour returned to a healthy pink. So,it was decided to preserve the tube. Since the tube was preserved, I went ahead with Appendicectomy. I had two reasons for removing the appendix - 1)A grossly normal looking appendix may not be normal 2)Since the tube was being preserved, diagnostic disparity if pain recurred would have been removed. Histopathology report showed Appendix with atrophy & serositis Am I right in removing the appendix in this particular case |
|
re: Acute Abdomen in pregnancy
by Dr M.K. Gupta -
Jan 11th, 2012
10:28 pm
#1
|
|
|
Dr M.K. Gupta
|
Dear Dr G Phanipriya If any obvious cause of pain is present innocent looking appendix may not be removed but Incidental appendectomy is considered to eventually be necessary in women with ovarian or tubal diseases and chronic pelvic pain, as the many of the appendices are found to have histopathologically confirmed pathology although being macroscopically normal (Wie et al., 2008). Incidental appendectomy is reported to be safe and effective in women undergoing gynaecologic surgery, in women with chronic pelvic pain and in our opinion your decision was correct. With regards M.K. Gupta |
If you have a surgical concern and can’t reach a doctor right away, or you’re not sure where else to ask a qualified laparoscopic surgeon, you can get our Medical Help through this Forum of World Laparoscopy Hospital which is available 24 hours a day, Just fill-up the form given and within few our the answer of your question will be posted on this forum. Please keep in mind we answer the question only related to laparoscopic surgery. You can also search and browse thousands of answer already posted on this forum
Using Free Medical Advice Related to Laparoscopic Surgery Service, you can send your questions to our Laparoscopic Surgeon and the Doctor will reply within few hour. It’s as if you are having an email exchange with your very own private surgeon! As soon as you post your question, a qualified laparoscopic surgeon will start answering it. Our expert can help you learn more about the treatment and procedure options available to you for different health problems and diseases.They’ll also give you information to discuss with your doctor when deciding what kind of surgical treatment is best for you.
The Doctor will provide you with the all the medical information you need, and will guide you as you choose a course of action, all from the comfort of your home or office. No more sitting in the waiting room for hours just to get some basic information from your laparoscopic surgeon; no more self-diagnosis after reading pages and pages of confusing and contradictory Online information.
World Laparoscopy Hospital gives you the personalized health information you need to decide on the right treatment for you. The information that you provide will be seen by every person for education and information purpose so please not write your real name.
