APENDICITIS U RANOM PUERPERIJU: PRIKAZ BOLESNICE

Appendicitis is the most common nonobstetric surgical diagnosis in pregnancy, but the diagnosis during immediate postpartum period is exceptionally rare. The case of a 27 year-old puerpera who survived a rather unspecific clinical course of the disease is presented. Initial abdominal symptoms had occurred two days before term delivery but the signs of abdominal disease had been obscured by the preparation for the process of the delivery and usual complaints during the early puerperium. A day after delivery, puerpera again complained of nausea and vomiting. The abdomen was somewhat tender, but without defense, laboratory parameters were within normal limits and abdominal X rays revealed nothing suspicious, so conservative therapy was initially administered. During the next two days meteorism occurred, abdominal tenderness increased and the laboratory findings deteriorated. Now abdominal X rays prompted urgent explorative¬ laparatomy and the patient was saved.Apendicitis je najučestalija neobstetrička dijagnoza u trudnoći koja zahtijeva kirurški zahvat, dok je u ranom postpartalnom periodu iznimno rijetka. Prikazat ćemo 27-godišnju babinjaču s vrlo neobičnim kliničkim tijekom bolesti. Inicijalni abdominalni simptomi pojavili su se dva dana prije termina poroda, ali su znaci karakteristični za akutni abdomen bili prikriveni samim početkom poroda, te uobičajenim smetnjama tijekom puerperija. Dan nakon poroda babinjača se ponovo žalila na mučninu i povraćanje. Abdomen je bio osjetljiv, ali bez defansa, laboratorijski parametri u granicama normale, a rendgenski nalaz uredan, pa je primijenjeno konzervativno liječenje. Tijekom iduća dva dana pojavio se meteori¬zam, abdominalna osjetljivost je porasla, a laboratorijski nalazi su se pogoršali. Prema rendgenogramu indicirana je hitna eksplorativna laparotomija te je pacijentica uspješno zbrinuta