GI EMERGENCIES · MEMBERSHIP SURGERY

Appendicitis at 22 weeks — 28F, Korle Bu antenatal

12 decision points ~22 min Difficulty 4/5 Membership

Setting

You are the surgical registrar at Korle Bu called to the antenatal ward. USS and MRI are available on call; CT is available but generally avoided in pregnancy; obstetrics and anaesthesia are co-consulted.

Patient

Mrs A, a 28-year-old teacher at 22 weeks in her second pregnancy, presents with 18 hours of central abdominal pain migrating to the right flank, anorexia, nausea and one episode of vomiting. Vitals BP 118/72, HR 104, temp 37.8. Fundus 4 fingers above the umbilicus; on the right side above and lateral to McBurney's point there is focal tenderness and guarding. Fetal heart heard, normal.

Reference stack

Bailey & Love 28e Ch 71 · Sabiston 21e Ch 51 · SAGES 2017 pregnancy guidelines · WSES 2020 acute appendicitis

Start cascade →

You'll be asked to decide what happens next at each step. There's no timer — take your time. The correct answer + evidence-anchored rationale is revealed after each choice.