妊娠32週目に発症した切迫早産を伴った急性虫垂炎に対して腹腔鏡下虫垂切除術を施行した1例

Laparoscopic appendectomy for a 32-week pregnant patient accompanied by threatened premature labor : A case report

◆要旨：本邦における妊娠後期の虫垂炎に対する腹腔鏡下手術の報告例は非常に稀である．患者は32歳，女性．妊娠32週目に下腹部痛を主訴に当院を受診し，切迫早産を伴う急性虫垂炎と診断し，同日緊急手術を施行した．自施設における過去の症例報告をもとに腹腔鏡下手術を選択し，安全に手術を施行しえた．術後経過は良好であり，切迫早産の増悪や胎児異常を認めず，第16病日に退院となった．腹腔鏡下虫垂切除術は，妊娠後期においても安全に施行可能であると考えられた．

Reports of laparoscopic surgery for appendicitis in late pregnancy in Japan are very rare. A 32-years old woman in 32nd week of pregnancy visited our hospital with a complaint of lower abdominal pain. A diagnosis of acute appendicitis accompanying premature birth was made and she underwent emergency surgery. Based on past case reports in our facility, we chose to perform laparoscopic appendectomy. Postoperative course was uneventful ; no exacerbation of premature birth or fetal abnormality was observed. The patient was discharged on the 16th day. Laparoscopic appendectomy was considered to be a safe and effective treatment even in late pregnancy.