Role of Abdominal Ultrasound and Magnetic Resonance Imaging in Pregnant Women Presenting With Acute Abdominal Pain

Acute Abdomen in Pregnancy: A Comprehensive Review of Diagnosis and Management

An unusual diagnostic and treatment challenge is presented by an acute abdomen during pregnancy. Obstetric factors and other causes unrelated to pregnancy also contribute to acute abdominal discomfort in pregnancy. Due to the changing clinical presentations brought on by the anatomical and physiological changes of pregnancy as well as the hesitation to utilize certain radiological studies out of concern about damaging the fetus, the diagnosis of the acute abdomen during pregnancy can be challenging. Delays in identification and treatment may have negative effects on the mother as well as the fetus. This review sheds light on the importance of anatomical and physiological considerations, early diagnoses, and understanding the various modalities and etiologies of acute abdomen in pregnancy (AAP). We then move on to discuss the various diagnostic techniques that can help the physician determine the causes and plan well-informed treatment. We examine and contrast different radiographic tests, including X-rays, computed tomography, magnetic resonance imaging, and ultrasound. We also talk about the various roles that these investigational methods can play in the evaluation and treatment throughout the duration of the pregnancy. The paper additionally addresses how to handle patients who appear with AAP and the different techniques used to treat them, including pre-operative laparoscopy. Before going over some more broad points that might be useful, we eventually dive into some of the more intriguing etiologies relating to AAP, such as isolated tubal torsion and neoplastic complications.

Laparoscopic surgery for fallopian tube torsion due to benign tumour in the third trimester of pregnancy: a case report and literature review

Isolated fallopian tubal torsion is rare among women of reproductive age, and it is even rarer during pregnancy. Despite its rare incidence, it is important to consider this diagnosis to facilitate prompt and effective intervention. We present the case of a pregnant woman in her third trimester who presented with acute right abdominal pain. A 32-year-old primigravida woman at 29 weeks and four days of gestation visited the emergency department with acute right flank and abdominal pain. Sonography and MRI revealed the presence of a right adnexal cystic mass. Exploratory laparoscopy revealed isolated right tubal torsion and a normal ovary. To avoid torsion recurrence, we performed laparoscopic right salpingectomy. The remainder of her gestation was uneventful. Histopathological examination revealed serous cystadenoma with haemorrhagic infarction. We reviewed the literature for cases of isolated tubal torsion in the past 11 years. Twenty-three case reports were included in this study, and the average time from presentation to surgical intervention was 35.6 hours. In these cases, most of the patients underwent laparotomy and had good pregnancy outcomes. Although the approach may vary depending on the situation, the laparoscopic approach should be preferred to laparotomy in the third trimester of pregnancy.