Twin In-vitro Fertilisation Pregnancy Complicated with Appendicular Perforation: A Case Report

Abstract

Appendicitis is an infection and inflammation of the appendix, a finger-shaped pouch that projects from the colon. It is a frequent and severe disorder that can appear anytime during pregnancy. It needs to be diagnosed and treated immediately. Otherwise, there would be a high risk of morbidity and mortality. Diagnosis is challenging due to the absence of the disorder’s typical clinical image, the ambiguity of its symptoms, and the frequency with which they occur during pregnancy. Due to the gravida uterus’s ability to displace the appendix within the abdomen, pregnancy may conceal the diagnosis and make it challenging to examine the patient physically. Obstacles in diagnosis caused by pregnancy lead to significantly increased risk to both the mother and foetus and raise the possibility of foetal loss following a negative appendicectomy. Usually, the biochemical and analytical tests used to diagnose this disease are unreliable during pregnancy. This is a case of a 38-year-old female primigravida who was 31 weeks pregnant with twins conceived via In-Vitro Fertilisation (IVF) and was diagnosed with acute appendicitis. She had surgery without complication and had a necrosed appendix, which was confirmed by histopathology. This report covers, in general terms, how to diagnose, treat, and manage a ruptured appendix with surgery and antibiotics with multidisciplinary management of such patients to improve their outcomes.