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Appendicitis in pregnancy — RCPSC EM MCQ

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ModerateGI/Abdominal emergenciesAppendicitis in pregnancyRCPSC EM

CTAS 3: A 24-week pregnant patient has right-sided abdominal pain, anorexia and vomiting. Vitals are T 38.1°C, HR 112, BP 112/70. Exam shows right flank tenderness because the uterus displaces the appendix. Urinalysis is negative. What is the most appropriate investigation?

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Correct answer: B — Graded-compression ultrasound followed by MRI if nondiagnostic

In stable pregnancy, ultrasound is usually first-line for suspected appendicitis, with MRI useful when ultrasound is nondiagnostic. Surgical consultation remains important.

Reference: SOGC imaging in pregnancy principles; Canadian surgical emergency practice