ROLE AND PLACE OF MODERN TECHNOLOGIES IN DIAGNOSIS AND TREATMENT OF ACUTE APPENDICITIS IN PREGNANT WOMEN

Aim. To improve the results of treatment of patients with acute appendicitis by means of optimization of therapeutic and diagnostic tactics based on use of ulrasonographic and videolaparoscopic technologies. Materials and methods. Among 1190 patients hospitalized for acute appendicitis, 67 (5,3%) women had pregnancy. During clinicolaboratory study and dynamic observation, appendicitis was not confirmed in 27 of them. Out of 53 pregnant women who underwent preoperative sonographic study, reliable and indirect signs of acute appendicitis were detected in 40 (75,8%) women, 4 were diagnosed abdominal pregnancy. Indirect symptoms of acute appendicitis were observed in 8 (15,1%) patients. According to the results of our study, US sensitivity was 75,8%, specificity - 97,7%, precision - 92,1%; ten pregnant women experienced diagnostic laparoscopy. We managed to visualize the vermiform appendix in 8 (80%) and to determine the absolute signs of inflammation in 6 women. Results. Forty of them were operated - in 34cases using Volkovich-Diakonov traditional access and in 6 cases - laparoscopic appendectomy in the first half of pregnancy. The postoperative complications in the form of infection in the region of operative intervention were observed in 4 (11,6%) women after traditional appendectomy, no complications were noted after laparoscopy. Conclusions. Successive use of ultrasonic and laparoscopic technologies permits to diagnose acute appendicitis and operate pregnant women in proper time and to decrease percent of unnecessary surgeries in case of diseases simulatimg acute appendicitis.

Acute appendicitis, pregnancy, ultrasonography, videolaparoscopy