Postpartum acute appendicitis: high index of suspicion and prompt intervention. A Case report.
Background: Postpartum sepsis is assumed to be related to pregnancy causes. Acute appendicitis should not be ignored, as it could be the most common non obstetric cause of pelvic septic condition in females. Proper and early diagnosis of acute appendicitis in postpartum period could reduce the morbidity rate. Case presentation: A 20-year-old female gravida 1 para 1, on 25th day postpartum, has presented with acute lower abdominal pain and fever commenced 5 days prior to admission and treated as postpartum sepsis. Her Hb was 9 mg/dl, WBC was 18.200. Late abdominal ultrasound evaluation showed acute appendicitis. Laparoscopic intervention revealed a suppurative acute appendicitis. Discussion: Acute appendicitis is rarely reported in the postpartum period. Diagnosis is usually difficult due to atypical presentation, and the overlap of postpartum sepsis, along with the altered physiology. It demands qualified diagnostic work up. Laparoscopic intervention was considered ideal for accurate diagnosis and management. Conclusion: Acute appendicitis in postpartum period could be the cause of refractory, non-obvious focus of sepsis with serious complications. The high index of suspicion and accurate follow up are mandatory for early detection. An early intervention could strongly reduce the rate of serious complications.
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