Ruptured appendix in pregnancy: a case report

Abstract

Objective: To present a report on a case of ruptured appendix in pregnancy and highlight the importance of prompt diagnosis and treatment to reduce maternal and fetal demise
Patient and Method: This was a 23 years old para 0+0 lady at 30weeks and 6days of gestation, who had unrelieved abdominal pain with analgesics and antacids prescribed by her physician, consulted a traditional birth attendant (TBA) who associated her pain to her oblique lying fetus; a diagnosis made from the ultrasound report. She was treated with vaginal and abdominal manipulation to correct the lie of the fetus. Thereafter her pain became worse and associated with increasing abdominal distension. She was referred to the University of Benin Teaching Hospital (UBTH) ten days after the onset of symptoms, evaluated and diagnosed to have ruptured appendix for which she had exploratory laparotomy.
Results: The findings were ruptured appendix, malodorous and faeculent pyoperitoneum of about 2000mls in volume and intact 30weeks size uterus. There was however fetal demise about the 4th post operative day. Mother’s condition gradually improved on the ward and was discharged 14th post operative day.
Conclusion: Appendicitis should be one of the differential diagnosis when a pregnant woman complains of abdominal pain. A thorough history and physical examination are the best indicators for confirming diagnosis. A delay can lead to perforation with increased risk of maternal and fetal demise.