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Appendicitis post recent cesarian section

Case contributed by Chris O'Donnell
Diagnosis almost certain

Presentation

Recent delivery of child by lower uterine segment cesarean section. Now lower abdominal pain ? post-operative pelvic or wound collection

Patient Data

Age: 25 years
Gender: Female

Enlarged uterus with gas in the endometrial cavity. No post-operative collection. Typical features of acute appendicitis with thickening of the wall, inflammation in surrounding fat and appendicoliths at the base and more distally.

Case Discussion

Appendicitis is not more common in pregnancy or post-partum but often has a delayed diagnosis.  Postpartum right lower quadrant pain has a differential diagnosis and most importantly one must consider ovarian vein thrombosis as well as post-operative complications following LUSCS including hematoma, abscess, wound sepsis and bladder injury.

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