appendicitis-1 - Appendicitisduring Appendicitisduring...

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Appendicitis during  Appendicitis during  pregnancy pregnancy Rinat Gabbay April 2002
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Appendicitis: Appendicitis: The most common surgical condition of the abdomen Lifetime occurrence of 7% Peak incidence 10-30y The most common nonobstetric surgical intervention during pregnancy
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Pathogenesis: Pathogenesis: Appendiceal lumen obstruction : lymphoid hyperplasia fecaliths parasites foreign bodies crohn’s disease metastatic cancer carcinoid syndrome
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Incidence during pregnancy: Incidence during pregnancy: Incidence 0.05% 1:1000 pregnant women - appendectomy 1:1500 proved appendicitis 1 st trimester – 30% / 22% 2 nd trimester – 45% / 27% 3 rd trimester – 25% / 50% (Mourad,2000)
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Incidence during pregnancy: Incidence during pregnancy: Suggested relation with female sex hormones – incidence variations during the menstrual cycle . Reduced incidence of appendicitis during pregnancy, especially in third trimester Protective effect of pregnancy ? (Int J Epidemiol 2001 Dec;30(6):1281-5)
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symptoms : symptoms : Pain – RLQ / RUQ / Flank Anorexia Vomiting Nausea Pain migration Fever
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Physical examination: Physical examination: Tenderness – RLQ Rovsing sign Dunphy’s sign Psoas sign (retroperitoneal retrocecal appendix) Obturator sign (pelvic appendix) Rectal examination tenderness (cul-de-sac) Low grade fever
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Psoas sign Obturator sign
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Lab: Lab: CBC – WBC ( 80% 45% ) CRP Urinalysis - mild pyuria mild proteinuria mild hematuria
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D.D.: D.D.: surgical surgical
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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appendicitis-1 - Appendicitisduring Appendicitisduring...

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