Question:

Which of the following answer choices is false?
1. In pregnancy, acute abdominal pain may be related to abdominal or obstetric emergencies.
2. Among non-traumatic emergencies, appendicitis is the most common acute abdominal emergency in pregnant patients.
3. After appendicitis and bowel obstruction, cholecystitis and cholelithiasis represent the third cause of non-obstetric surgical emergencies in pregnancy.
4. Acute pyelonephritis is not observed in pregnancies.
5. In the diagnosis of appendicitis, MRI findings include the dilatation of appendix, with thickening of its wall.





Answer:

The correct answer for the question "Which of the following answer choices is false?" is:

4. Acute pyelonephritis is not observed in pregnancies.



Explanation
1. [Acute abdominal pain in pregnancies is caused by abdominal diseases -appendicitis, intestinal obstruction, cholecystitis and cholelithiasis - and also by obstetric diseases].

2. [Among non-traumatic emergencies, appendicitis is the most common cause of acute abdomen in the pregnant patient, affecting 1 in 1500 pregnancies; its incidence is very similar to that observed in the general population - 0.05-0.07%].

3. [After appendicitis and bowel obstruction, cholecystitis and cholelithiasis represent the third cause of non-obstetric surgical emergencies in pregnancy, occurring in 1 to 8 of 10000 pregnancies].

4. [Acute pyelonephritis occurs in 1% to 2% of pregnancies].

5. [In the diagnosis of appendicitis, MRI findings include the dilatation of appendix (>6 mm) with thickening of its wall, the presence of an intraluminal stump and the increased signal intensity in the pericecal fat and fluid collections].



From the manuscript:
Diagnosis of a sigmoid volvulus in pregnancy: ultrasonography and magnetic resonance imaging findings
Radiology Case. 2014 Feb; 8(2):54-62


This article belongs to the OB/GYN section.




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From the manuscript

Diagnosis of a sigmoid volvulus in pregnancy: ultrasonography and magnetic resonance imaging findings

Free full text article: Diagnosis of a sigmoid volvulus in pregnancy: ultrasonography and magnetic resonance imaging findings

Abstract
Sigmoid volvulus complicating pregnancy is a rare, non-obstetric cause of abdominal pain that requires prompt surgical intervention (decompression) to avoid intestinal ischemia and perforation. We report the case of a 31-week pregnant woman with abdominal pain and subsequent development of constipation. Preoperative diagnosis was achieved using magnetic resonance imaging and ultrasonography: the large bowel distension and a typical whirl sign - near a sigmoid colon transition point - suggested the diagnosis of sigmoid volvulus. The decision to refer the patient for emergency laparotomy was adopted without any ionizing radiation exposure, and the pre-operative diagnosis was confirmed after surgery. Imaging features of sigmoid volvulus and differential diagnosis from other non-obstetric abdominal emergencies in pregnancy are discussed in our report, with special emphasis on the diagnostic capabilities of ultrasonography and magnetic resonance imaging.






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