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. 2021 Jan;100(1):40-46.
doi: 10.4174/astr.2021.100.1.40. Epub 2020 Dec 30.

Magnetic resonance imaging reduces the rate of unnecessary operations in pregnant patients with suspected acute appendicitis: a retrospective study

Beatrice Lukenaite  1 , Raminta Luksaite-Lukste  2 , Saulius Mikalauskas  1 , Arturas Samuilis  2 , Kestutis Strupas  1 , Tomas Poškus  1
Affiliations

Magnetic resonance imaging reduces the rate of unnecessary operations in pregnant patients with suspected acute appendicitis: a retrospective study

Beatrice Lukenaite et al. Ann Surg Treat Res. 2021 Jan.

Abstract

Purpose: This is a retrospective single-institution study performed to compare the rate of unnecessary operations in pregnant women with suspected acute appendicitis with and without the use of MRI.

Methods: The study subjects were all pregnant women with suspected acute appendicitis admitted to a tertiary institution from January 2012 to December 2019. If acute appendicitis was not excluded clinically and by ultrasound (US), laparoscopies were performed until May 2017 (US-only group). MRI was added as a diagnostic tool when US was inconclusive from May 2017 (US + MRI group). Surgery was considered unnecessary when no inflamed appendix was found. The rate of unnecessary surgery, postoperative complications, length of stay were analyzed.

Results: Seventy-six women were included in the study; 38 women in the US-only group and 38 women in the US + MRI group. There were no differences in admission characteristics between the groups. One of 38 women (2.6%) underwent unnecessary surgery in the US + MRI group vs. 10 of 38 (26.3%) in the US-only group (P = 0.007). The patients in the US + MRI group were significantly less likely to undergo a diagnostic operation than in the US-only group (5.26% vs. 55.3%, respectively; P < 0.001) and their hospital stay was significantly shorter (0.74 ± 1.64 days vs. 3.7 ± 3.0 days, respectively; P < 0.001). The obstetric outcomes were not different between the groups. MRI had a sensitivity of 83.3% and specificity of 100% in the series.

Conclusion: The rate of unnecessary surgery was significantly reduced in pregnant women, who underwent MRI after inconclusive transabdominal US.

Keywords: Appendicitis; Diagnostic imaging; Magnetic resonance imaging; Pregnancy.

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Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Diagnostic algorithms or pregnant women with suspected acute appendicitis. Before (A) and after (B) introduction of MRI. US, ultrasound.
See this image and copyright information in PMC

References

    1. Kryzauskas M, Danys D, Poskus T, Mikalauskas S, Poskus E, Jotautas V, et al. Is acute appendicitis still misdiagnosed? Open Med (Wars) 2016;11:231–236. - PMC - PubMed
    1. Bhangu A RIFT Study Group on behalf of the West Midlands Research Collaborative. Evaluation of appendicitis risk prediction models in adults with suspected appendicitis. Br J Surg. 2020;107:73–86. - PMC - PubMed
    1. Kave M, Parooie F, Salarzaei M. Pregnancy and appendicitis: a systematic review and meta-analysis on the clinical use of MRI in diagnosis of appendicitis in pregnant women. World J Emerg Surg. 2019;14:37. - PMC - PubMed
    1. De Wilde JP, Rivers AW, Price DL. A review of the current use of magnetic resonance imaging in pregnancy and safety implications for the fetus. Prog Biophys Mol Biol. 2005;87:335–353. - PubMed
    1. Mourad J, Elliott JP, Erickson L, Lisboa L. Appendicitis in pregnancy: new information that contradicts long-held clinical beliefs. Am J Obstet Gynecol. 2000;182:1027–1029. - PubMed

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