Abstract:
Introduction. Non-obstetric abdominal emergencies in pregnant women complicates one of 500-700 pregnancies, requiring surgical intervention in 0.2 to 2% of cases. The clinical presentation is misleading due to the anatomical and physiological changes associated with pregnancy, which are responsible for hesitating the diagnosis.
Material and methods.
The objective of this review is to recall the anatomical-physiological particuliarities of the pregnant
woman, to describe these main medical-surgical abdominal emergencies and to specify the particularities of their diagnostic and therapeutic management.
Results.
The most frequent abdominal emergencies are: acute appendicitis (0.2%) - whose first-line
treatment is laparoscopic appendectomy, acute cholecystitis (0.05%) - most often lithiasis,
for which the first-line treatment is laparoscopic cholecystectomy from the I to the
beginning of the III trimester, intestinal occlusions (0.02%) - for which the indications for
medical or surgical treatment remain the same as in the absence of pregnancy. Acute
pancreatitis has a lower incidence (0,03-0.025%), is generally lithic, and most often
responds to medical treatment, but is associated with a high recurrence rate, justifying
laparoscopic cholecystectomy in the second trimester, or endoscopic treatment in the
third trimester.
Conclusions.
Abdominal surgical emergencies in pregnancy are real challenges for clinicians and require
a multidisciplinary approach taking into account all the patient physiological and
anatomical peculiarities, as well as fetal safety.
