Peritoneovaginal Fistula and Appendicitis-Related Pelvic Abscess in Pregnancy

• Main Authors: Mona Saleh (Author), Antonia Francis Kim (Author), Andrew Gardner (Author), Katherine Sun (Author), Sara Brubaker (Author)
• Format: Book
• Published: Thieme Medical Publishers, Inc., 2020-04-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2157-6998; 2157-7005; 10.1055/s-0040-1708849
• Keywords: peritoneovaginal fistula; acute appendicitis during pregnancy; appendiceal endometriosis; appendiceal abscess; Gynecology and obstetrics; RG1-991
• Source: American Journal of Perinatology Reports, Vol 10, Iss 02, Pp e129-e132 (2020)

Appendicitis in pregnancy is the most common nonobstetric surgical emergency. Pregnancy causes changes in anatomy, which could lead to uncertainty regarding the diagnosis of appendicitis. This case report describes a case of appendicitis presenting with peritoneovaginal fistula in a pregnant woman in the second trimester, with interesting finding of isolated appendiceal endometriosis on pathology. The importance of complete physical examination, including speculum examination, is emphasized in the pregnant patient presenting with acute-onset abdominal pain. Imaging criteria for diagnosis of appendicitis should be adjusted to account for the gravid uterus, which may cause appendiceal abscess to appear in a variety of locations, such as posterior to the cervix, as in this case.