Revisiting MRI for Appendix Location During Pregnancy (original) (raw)
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2021
Abdominal pain frequently represents a diagnostic challenge in an emergency clinical setting. Acute appendicitis tops the most common extra-uterine surgical emergency encountered during pregnancy. An accurate diagnosis of acute appendicitis is still uncertain due to the physical and physiological changes that occur during the course of pregnancy. Familiarity with reliable diagnostics may improve diagnostic accuracy and enable the quickest and most appropriate clinical management. When clinical examinations and ultrasound findings are inconclusive, Magnetic Resonance Imaging being highly sensitive and specific can be used as an alternate diagnostic entity for clinically suspected acute appendicitis in pregnant women. It is an excellent imaging technique with negative exposure of the fetus or the mother to ionizing radiation that pave a reliable option for pregnant patients with suspected acute appendicitis. A review appraisal on diagnostic techniques and accuracy of Magnetic Resonanc...
Acute appendicitis is the most common cause of acute surgical abdomen during pregnancy. Our study was conducted to review our experience and diagnostic accuracy with MRI during pregnancy and clinical outcomes over a two year period. All pregnant women who underwent an MRI examination of the abdomen between January 2008 and January 2010 at Spectrum Health hospitals were included in the study. We retrospectively reviewed the medical records and MRI findings in 46 pregnant women. 46 pregnant women underwent a total of 53 MRI scans and of these, 23/46 (50%) presented with RLQ pain and other signs suspicious for appendicitis. 10/23 (43%) had MRI findings positive for acute appendicitis: 5/10 (50%) had uncomplicated acute appendicitis by MRI criteria, all were confirmed at surgery. 3/5 had a ruptured appendix with abscess, 1/5 had a perforated appendix with abscess and 1/5 had MRI findings suspicious for appendicitis but was discharged without surgery or further follow up. The sensitivity for diagnosing appendicitis by MRI in our 10 patients with positive findings was 89% (8 of 9 cases, with one case lost to follow up). The specificity was 100%, since all of the patients who had a normal appendix and/or no secondary signs of appendicitis on MRI were managed medically and were discharged without readmission for surgery. The negative predictive value (NPV) was 93% (13/14). Our study shows that MRI of the abdomen without contrast is an excellent alternative to CT and ultrasound for diagnosing and excluding acute appendicitis during pregnancy. Our study was conducted to review our experience at Spectrum Health to evaluate our diagnostic accuracy with MRI during pregnancy and clinical outcomes over a two year period. Materials and Methods Patients IRB approval was obtained. All pregnant women who underwent an MRI examination of the abdomen between January 2008 and January 2010 at Spectrum Health hospitals were included in the study. We retrospectively reviewed the medical records and MRI findings in 46 pregnant women (age range, 17-39; mean age 28). Eleven patients were in the first trimester, 20 patients were in the second trimester, and 15 patients were in the third trimester. Out of this group, women presenting with right lower quadrant pain and clinical concern for acute appendicitis were identified. The MRI used, as well as the image interpretation performed at the time of the procedure, are described below.
MR Imaging Evaluation of Acute Appendicitis In Pregnancy1
Radiology, 2006
Materials and Methods: The study was approved by the committee on clinical investigations and was HIPAA compliant. The informed consent requirement was waived. MR images were obtained in 51 consecutive pregnant patients (mean age, 28.3 years) who were clinically ...
Location of appendix in pregnancy: does it change?
Clinical and experimental gastroenterology, 2018
This study aimed to determine the change in anatomical location of appendix in full-term pregnancy. This was a descriptive cross-sectional study. Liaquat National University Hospital, Karachi, Pakistan, Department of General Surgery, January 01 to July 31, 2010. Full-term pregnant women undergoing caesarean section were enrolled. The anatomical position of the appendix was noted by visual inspection with reference to the transtubercular plane (TTP). SPSS-10 was used for analysis. Seventy-seven full-term pregnant female patients who underwent caesarean section were included in the study. Their mean age was 29 years, the mean height was 5.3 feet, and mean gestational age was 38 weeks. Appendix was found at the normal anatomical location in 63 out of 77 patients (81.8%), while it was located above the TTP in 14 patients (18.2%). Appendix does not migrate up with increasing gestational age in the majority of pregnant women. In most full-term pregnant female patients, appendix is located...