Subphrenic Abscess after Appendiceal Rupture in Full-Term Pregnancy
| Autor: | Theodoros Stefos, Georgios K. Glantzounis, Georgios Michos, Anna Goussia, Ioannis Gizas, Christos Papadopoulos, Georgios K. Georgiou |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Microbiology (medical) medicine.medical_specialty Exploratory laparotomy medicine.medical_treatment Subphrenic abscess Perforation (oil well) Peritonitis Pregnancy Humans Medicine Pregnancy Complications Infectious Rupture Subphrenic Abscess business.industry Appendicitis medicine.disease Surgery Infectious Diseases Female Right Lumbar Region Tomography X-Ray Computed business Complication |
| Zdroj: | Surgical Infections. 16:204-205 |
| ISSN: | 1557-8674 1096-2964 |
| DOI: | 10.1089/sur.2013.234 |
| Popis: | Acute appendicitis, although a rare event during pregnancy, is associated with a raised incidence of premature labor and increased maternal morbidity [1]. Complications such as perforation and peritonitis are more common due to the delay in diagnosis and management [2]. Especially in cases of peritonitis, the rate of this complication may be as high as 35% [3]. We present a rare case of ruptured retro-cecal appendicitis in the third trimester of pregnancy with atypical presentation. A 25-year-old female patient at the 33 week of pregnancy presented with pain at the right lumbar region, leukocytosis, and right renal pelvis dilatation on ultrasound (U/S), but no fever. Initial diagnosis was that of right renal colic and was treated as such. Following clinical deterioration, and a significant drop in hematocrit, she underwent abdominal U/S and magnetic resonance imaging (MRI). A large sub-diaphragmatic collection was found, which at first was believed to be a subcapsular liver hematoma. It was initially managed conservatively. Delivery was successfully performed through caesarean section after preparation with corticosteroids. Two days after delivery, the patient developed symptoms and signs of septic shock. Broad-spectrum antibiotics were administered and the sub-diaphragmatic collection was drained percutaneously under computed tomography (CT) guidance. The collection was a large subphrenic abscess. Six months later the patient underwent exploratory laparotomy, in which remnants of a ruptured appendix were discovered in the right sub-hepatic space and removed. |
| Databáze: | OpenAIRE |
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