PAEA Surgery End Of Rotation (EOR) Practice Exam

What is the first-line imaging study for diagnosing appendicitis in pregnant women?

1. X-ray

2. Ultrasound

3. MRI

4. CT scan

The correct answer is: Ultrasound

The first-line imaging study for diagnosing appendicitis in pregnant women is ultrasound. This is primarily due to the concern for fetal exposure to radiation, which makes other imaging modalities like X-ray and CT scan less desirable in this population. Ultrasound is a safe, non-invasive procedure that does not involve radiation and can effectively visualize the appendix and surrounding structures. This imaging technique can help identify signs of appendicitis, such as an enlarged, non-compressible appendix or periappendiceal fluid. Additionally, ultrasound can be particularly advantageous in evaluating the abdominal pain of pregnant women, as it can also provide valuable information about other potential conditions that may mimic appendicitis, such as adnexal pathology or obstetric complications, without the risks associated with ionizing radiation found in CT scans. In certain cases, if the ultrasound findings are inconclusive and there is still a high suspicion of appendicitis, further evaluation with an MRI might be considered, but this is not typically the first-line choice due to availability and practicality.