In fertile women the diagnosis of acute appendicitis is a challenge for the surgeon. A negative surgical exploration of the abdomen is not uncommon. The purpose of our study was two fold: to stablish a probability diagnostic index of acute abdomenfor fertile women and the value of the videolaparoscopy of the abdomen for the diagnosis and therapeutic in this group of patients. Thirty-four women with clinical and laboratory data suggesting acute appendicitis were divided into three groups according to the probability of having the disease: high, medium and low probability. Following that, all thirty-four patients were submitted to videolaparoscopic evaluation of the abdomen. If necessary, an appendectomy was carried out with the same procedure. According to our probability index, we observed: ten patients were classified as being low probability, twelve as being medium probability and twelve as being high probability. The results showed that in the low probability group only two patients (20%) had confirmed appendicitis. In the medium probability group, six patients (50%) had confirmed acute appendicitis. In the high probability group, nine patients (75%) had the diagnosis confirmed. From our study we concluded that fertile women who fit the high and medium probability group should have an immediate laparoscopic evaluation of the abdomen. Fertile women who fit the low probability group, will not be jeopardized if a period of clinical observation is undertaken.
Acute abdome; Videolaparoscopy; Acute appendicitis