International Journal of Academic Health and Medical Research (IJAHMR)   Year: 2024 | Volume: 8 | Issue: 2 | Page No.: 24-28 Appendicite gangréneuse simulant un tableau d'infection intra-utérine Download PDF Mochtari Houda, M. Bendahhou Idrissi, N. Mamouni, S. Errarhay, C. Bouchikhi, A. Banani Abstract: Acute Appendicitis represents the most common non-obstetric surgical emergency during pregnancy, since its incidence is 0.02 to 0.05%. Pregnancy does not change the overall incidence of appendicitis, but the severity of this surgical condition may be increased in pregnancy. Appendicitis seems to be more common during the second trimester. The diagnostic difficulty of AA in pregnancy actually depends on gestational age. Thus, in the first trimester, the clinical picture is that of classic AA. On the other hand, in the second and third trimesters, the diagnosis is more difficult, on the one hand, because of the high position of the cecum and, on the other hand, because of the existence of uterine contractions suggesting a threat of childbirth. premature and can delay or even misplace the diagnosi. In our reported case, the clinical picture was different, the patient presented with suprapubic pelvic pain in a pregnancy of 17 weeks after an attempted clandestine abortion, the clinical examination found a stable pyretic patient with a supple abdomen. and absence of cervical changes, the ultrasound showed a still evolving pregnancy, the evolution was marked by the spontaneous rupture of the bag of waters with a worsening of the pelvic pain and the infectious assessment, the decision was to trigger the patient before the strong suspicion of intrauterine infection, during monitoring and after several misoprostol applications the patient developed a continuous fever with always the same cervical findings, hence the decision to admit her to the operating room for cesarean section. Exploration showed the presence of gangrenous appendicitis of retro-uterine location with a digested appendix. The procedure consisted of an appendectomy with extraction of the newborn. The postoperative evolution was favorable with clinical and biological improvement.