OBJECTIVE: Assess the performance of ultrasound (US) in pregnant patients presenting with acute abdominal pain concerning for appendicitis. METHODS: Descriptive analysis of pregnant patients who underwent an US for acute abdominal pain over a 6-year period using data from a statewide quality improvement collaborative and a single center. RESULTS: Statewide, 131 pregnant patients underwent an appendectomy and 85% had an US. In our single-center case series, 49 pregnant patients underwent an US for acute abdominal pain and four patients had appendicitis (8%). Of those, three were definitively diagnosed with US. The appendix was visualized by US in five patients (3 appendicitis/2 normal). Mean gestational age was 11 weeks for visualization of the appendix versus 20 weeks for non-visualization (p < 0.001). Concordance between US and pathology was similar statewide and at our institution (43%). CONCLUSIONS: US appears to play a central role in the evaluation of appendicitis in pregnant women, especially in the first trimester, and often contributes to definitive disposition. US performed less well in excluding appendicitis; however, in certain clinical settings, providers appeared to trust US findings. From these results, we developed a multidisciplinary imaging pathway for pregnant patients who present with acute abdominal pain concerning for appendicitis.
OBJECTIVE: Assess the performance of ultrasound (US) in pregnant patients presenting with acute abdominal pain concerning for appendicitis. METHODS: Descriptive analysis of pregnant patients who underwent an US for acute abdominal pain over a 6-year period using data from a statewide quality improvement collaborative and a single center. RESULTS: Statewide, 131 pregnant patients underwent an appendectomy and 85% had an US. In our single-center case series, 49 pregnant patients underwent an US for acute abdominal pain and four patients had appendicitis (8%). Of those, three were definitively diagnosed with US. The appendix was visualized by US in five patients (3 appendicitis/2 normal). Mean gestational age was 11 weeks for visualization of the appendix versus 20 weeks for non-visualization (p < 0.001). Concordance between US and pathology was similar statewide and at our institution (43%). CONCLUSIONS: US appears to play a central role in the evaluation of appendicitis in pregnant women, especially in the first trimester, and often contributes to definitive disposition. US performed less well in excluding appendicitis; however, in certain clinical settings, providers appeared to trust US findings. From these results, we developed a multidisciplinary imaging pathway for pregnant patients who present with acute abdominal pain concerning for appendicitis.
Authors: Max P Rosen; Alexander Ding; Michael A Blake; Mark E Baker; Brooks D Cash; Jeff L Fidler; Thomas H Grant; Frederick L Greene; Bronwyn Jones; Douglas S Katz; Tasneem Lalani; Frank H Miller; William C Small; Stephanie Spottswood; Gary S Sudakoff; Mark Tulchinsky; David M Warshauer; Judy Yee; Brian D Coley Journal: J Am Coll Radiol Date: 2011-11 Impact factor: 5.532
Authors: Lodewijk P Cobben; Ingrid Groot; Lucien Haans; Johan G Blickman; Julien Puylaert Journal: AJR Am J Roentgenol Date: 2004-09 Impact factor: 3.959