Abstract
An acute abdomen in pregnancy is often challenging to diagnose. Physicians routinely encounter patients' hesitation regarding invasive interventions, difficulty in obtaining consent from patients and families, and restrictions on the use of diagnostic imaging modalities during pregnancy. This report presents a case of an acute abdomen during pregnancy, managed by laparoscopy. A 30-year-old female at 4 weeks, 4 days gestation was admitted to the hospital complaining of epigastric discomfort and lower abdominal pain. She was diagnosed with an acute abdomen and peritonitis; acute appendicitis or pelvic inflammatory disease was thought to be the probable cause. Abdominal ultrasonography was used to refine the differential diagnosis, but the findings were inconclusive. After consultation with general surgeons, the decision was made to administer antibiotic therapy. This treatment was effective, and she was discharged on day 11. She was hospitalized again on day 20 with recurrent abdominal pain. Abdominal ultrasonography was again performed but as before, the results were inconclusive. Although the use of computed tomography was suggested, the patient and her family did not consent. Therefore, she underwent laparoscopic surgery for both diagnosis and treatment. Laparoscopy revealed that her appendix was swollen with pus; appendectomy was performed based on a diagnosis of acute appendicitis. She recovered without any complications and was discharged on postoperative day 6.
