ACUTE APPENDICITIS IN A SINGLE AND MULTIPLE PREGNANCY – A STUDY OF TWO CASES

Appendicitis during pregnancy is a diagnostic and therapeutic problem.

Removal of the appendix due to acute inflammation is one of the most difficult surgeries performed when immediate indications are concerned. Diagnosis and a decision on eligibility for the surgery are based on clinical criteria, subjective data from an interview and physical examination. The reason for great diagnostic difficulties and the not-so-rare mistakes in diagnosis of pregnant women is the anatomy of the abdominal cavity altered by the uterus during pregnancy. Some of the symptoms of appendicitis may be mistakenly interpreted as symptoms occurring typically in pregnancy. In pregnant women, the decision on eligibility for surgery is of special importance, because one must take into consideration the threat to foetal health.

The diagnostic difficulties of differentiating this affliction in different trimesters of pregnancy in single and twin pregnancies have been discussed in the paper. An assessment was made of the influence of surgical treatment on further development of the pregnancy and development of the foetuses.

Both pregnancies ended in Caesarean sections. The first one in the 37th week due to obstetric indications – a twin pregnancy with breech presentation of the first foetus; the second one in the 37th week with a simultaneous removal of the appendix.