A case of elective laparoscopic appendectomy for repeat appendicitis done at 14 weeks of gestation

Abstract

A 27-year-old women had a history of repeat episodes of acute appendicitis ; she had had for 3 episodes of appendicitis within 6 months after her first delivery. After the fourth episode of appendicitis, she consented at last to surgery. However, prior to surgery, she was found to be pregnant, and the operation was delayed. At 6 weeks of gestation, a fifth episode of appendicitis occurred. As she hoped to continue with her pregnancy, an elective appendectomy was scheduled for the second trimester of pregnancy. In the meantime, conservative therapy was implemented ; fortunately, the patient responded favourably. At 14 weeks of gestation, a laparoscopic appendectomy was performed under general and epidural anesthesia with pneumoperitoneum. The patient was discharged 4 days after the operation, and at 40 weeks of gestation, she delivered her baby with no complications. Laparoscopic appendectomy for pregnant woman is not often done in Japan. Here, we report on the details of this rare case requiring surgery during pregnancy.