Appendizitis in der Schwangerschaft – Diagnostik, konservative Therapie und OP

Ingolf Juhasz-Böss; Russalina Ströder; Christoph Raspé; Erich-Franz Solomayer; Gabriele Meyberg-Solomayer; Amr Hamza

doi:10.1055/a-0660-6905

Frauenheilkunde up2date, Table of Contents

Frauenheilkunde up2date 2018; 12(06): 551-563
DOI: 10.1055/a-0660-6905

Geburtshilfe und Perinatalmedizin

Georg Thieme Verlag KG Stuttgart · New York

Appendizitis in der Schwangerschaft – Diagnostik, konservative Therapie und OP

Ingolf Juhasz-Böss

,

Russalina Ströder

,

Christoph Raspé

,

Erich-Franz Solomayer

,

Gabriele Meyberg-Solomayer

,

Amr Hamza

Abstract

All articles of this category

Eine Appendizitis während der Schwangerschaft stellt eine besondere Situation dar. Während die Appendektomie früher fast ausschließlich via Laparotomie erfolgte, ist heutzutage immer häufiger die Laparoskopie (LSK) die Methode der Wahl. Das Verfahren ist in geübten Händen auch in der Schwangerschaft sicher. Die Komplikationsraten sind insgesamt niedrig und die perioperative Morbidität ist bei der LSK gegenüber der Laparotomie deutlich niedriger.

Schlüsselwörter

Appendizitis - Schwangerschaft - Laparoskopie - Anästhesie - Appendektomie - konservative Therapie

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References

Literatur
1 Kammerer WS. Nonobstetric surgery during pregnancy. Med Clin North Am 1979; 63: 1157-1164
2 Kort B, Katz VL, Watson WJ. The effect of nonobstetric operation during pregnancy. Surg Gynecol Obstet 1993; 177: 371-376
3 Andersen B, Nielsen TF. Appendicitis in pregnancy: diagnosis, management and complications. Acta Obstet Gynecol Scand 1999; 78: 758-762
4 Petroianu A. Diagnosis of acute appendicitis. Int J Surg 2012; 10: 115-119
5 Kreis ME, Koch FEv, Jauch K-W. et al.. Abklärung des rechtsseitigen Unterbauchschmerzes. Dtsch Arztebl 2007; 104: A-3114/B-2738/C-2645
6 Richards C, Daya S. Diagnosis of acute appendicitis in pregnancy. Can J Surg 1989; 32: 358-360
7 Hardin jr. DM. Acute appendicitis: review and update. Am Fam Physician 1999; 60: 2027-2034
8 Erkek A, Anik Ilhan G, Yildizhan B. et al.. Location of the appendix at the third trimester of pregnancy: A new approach to old dilemma. J Obstet Gynaecol 2015; 35: 688-690
9 House JB, Bourne CL, Seymour HM. et al.. Location of the appendix in the gravid patient. J Emerg Med 2014; 46: 741-744
10 Mahmoodian S. Appendicitis complicating pregnancy. South Med J 1992; 85: 19-24
11 Franca Neto AH, Amorim MM, Nóbrega BM. Acute appendicitis in pregnancy: literature review. Rev Assoc Med Bras (1992) 2015; 61: 170-177
12 Wang LT, Prentiss KA, Simon JZ. et al.. The use of white blood cell count and left shift in the diagnosis of appendicitis in children. Pediatr Emerg Care 2007; 23: 69-76
13 Chandra S, Tripathi AK, Mishra S. et al.. Physiological changes in hematological parameters during pregnancy. Indian J Hematol Blood Transfus 2012; 28: 144-146
14 Coleman C, Thompson jr. JE, Bennion RS. et al.. White blood cell count is a poor predictor of severity of disease in the diagnosis of appendicitis. Am Surg 1998; 64: 983-985
15 Lurie S, Rahamim E, Piper I. et al.. Total and differential leukocyte counts percentiles in normal pregnancy. Eur J Obstet Gynecol Reprod Biol 2008; 136: 16-19
16 Bondi M, Miller R, Zbar A. et al.. Improving the diagnostic accuracy of ultrasonography in suspected acute appendicitis by the combined transabdominal and transvaginal approach. Am Surg 2012; 78: 98-103
17 Uebel P, Weiss H, Trimborn CP. et al.. [Ultrasound diagnosis of acute appendicitis-possibilities and limits of the method-results of prospective and retrospective clinical studies]. Ultraschall Med 1996; 17: 100-105
18 Lim HK, Bae SH, Seo GS. Diagnosis of acute appendicitis in pregnant women: value of sonography. AJR Am J Roentgenol 1992; 159: 539-542
19 Williams R, Shaw J. Ultrasound scanning in the diagnosis of acute appendicitis in pregnancy. Emerg Med J 2007; 24: 359-360
20 Patel D, Fingard J, Winters S. et al.. Clinical use of MRI for the evaluation of acute appendicitis during pregnancy. Abdom Radiol (NY) 2017; 42: 1857-1863
21 Latifi A, Labruto F, Kaiser S. et al.. Does enteral contrast increase the accuracy of appendicitis diagnosis?. Radiol Technol 2011; 82: 294-299
22 Frohlich JM, Kubik-Huch RA. [Radiographic, MR or ultrasound contrast media in pregnant or breast-feeding women: what are the key issues?]. Rofo 2013; 185: 13-25
23 Stacul F, van der Molen AJ, Reimer P. et al.. Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines. Eur Radiol 2011; 21: 2527-2541
24 Rosen MP, Ding A, Blake MA. et al.. ACR Appropriateness Criteria^® right lower quadrant pain–suspected appendicitis. J Am Coll Radiol 2011; 8: 749-755
25 Leeuwenburgh MM, Jensch S, Gratama JW. et al.. MRI features associated with acute appendicitis. Eur Radiol 2014; 24: 214-222
26 Long SS, Long C, Lai H. et al.. Imaging strategies for right lower quadrant pain in pregnancy. AJR Am J Roentgenol 2011; 196: 4-12
27 Karul M, Berliner C, Keller S. et al.. Imaging of appendicitis in adults. Rofo 2014; 186: 551-558
28 McBurney C. Experiences with early operative interference in cases of disease of the vermiform appendix. NY Med J 1889; 50: 1676-1684
29 Konstantinidis KM, Anastasakou KA, Vorias MN. et al.. A decade of laparoscopic appendectomy: presentation of 1,026 patients with suspected appendicitis treated in a single surgical department. J Laparoendosc Adv Surg Tech A 2008; 18: 248-258
30 Campbell MR, Johnston 3rd SL, Marshburn T. et al.. Nonoperative treatment of suspected appendicitis in remote medical care environments: implications for future spaceflight medical care. J Am Coll Surg 2004; 198: 822-830
31 Aivazian VP. [State of intramural neural apparatus of the vermiform process in “cecum mobile” syndrome]. Zh Eksp Klin Med 1975; 15: 70-76
32 Gurin NN, Slobodchuk IuS, Gavrilov IuF. [The efficacy of the conservative treatment of patients with acute appendicitis on board ships at sea]. Vestn Khir Im I I Grek 1992; 148: 144-150
33 Simillis C, Symeonides P, Shorthouse AJ. et al.. A meta-analysis comparing conservative treatment versus acute appendectomy for complicated appendicitis (abscess or phlegmon). Surgery 2010; 147: 818-829
34 Varadhan KK, Neal KR, Lobo DN. Safety and efficacy of antibiotics compared with appendicectomy for treatment of uncomplicated acute appendicitis: meta-analysis of randomised controlled trials. Br Med J 2012; 344: e2156
35 Vons C, Barry C, Maitre S. et al.. Amoxicillin plus clavulanic acid versus appendicectomy for treatment of acute uncomplicated appendicitis: an open-label, non-inferiority, randomised controlled trial. Lancet 2011; 377: 1573-1579
36 Hansson J, Korner U, Khorram-Manesh A. et al.. Randomized clinical trial of antibiotic therapy versus appendicectomy as primary treatment of acute appendicitis in unselected patients. Br J Surg 2009; 96: 473-481
37 Styrud J, Eriksson S, Nilsson I. et al.. Appendectomy versus antibiotic treatment in acute appendicitis. a prospective multicenter randomized controlled trial. World J Surg 2006; 30: 1033-1037
38 Eriksson S, Granstrom L. Randomized controlled trial of appendicectomy versus antibiotic therapy for acute appendicitis. Br J Surg 1995; 82: 166-169
39 Juhasz-Böss I, Solomayer E, Strik M. et al.. Abdominal surgery in pregnancy–an interdisciplinary challenge. Dtsch Arztebl Int 2014; 111: 465-472
40 Lemieux P, Rheaume P, Levesque I. et al.. Laparoscopic appendectomy in pregnant patients: a review of 45 cases. Surg Endosc 2009; 23: 1701-1705
41 McGory ML, Zingmond DS, Tillou A. et al.. Negative appendectomy in pregnant women is associated with a substantial risk of fetal loss. J Am Coll Surg 2007; 205: 534-540
42 Pearl J, Price R, Richardson W. et al., Society of American Gastrointestinal Endoscopic Surgeons. Guidelines for diagnosis, treatment, and use of laparoscopy for surgical problems during pregnancy. Surg Endosc 2011; 25: 3479-3492
43 Reedy MB, Galan HL, Richards WE. et al.. Laparoscopy during pregnancy. A survey of laparoendoscopic surgeons. J Reprod Med 1997; 42: 33-38