The dilemma of incidental gynecological disorders in the general surgical practice

Abstract AR

Background & Objective .: The general surgeon may be confronted with several gynecological disorders that can present as an acute abdomen, more specifically acute appendicitis.

Some of these disorders may not need surgical interference.

The objective of the study was to investigate the incidental finding of gynecological disorders in a routine general surgical practice in Baghdad, Iraq, and to determine incidence, types, and features of these conditions that differentiate them from surgical diseases in order to avoid unnecessary surgical procedures.

Methods: This retrospective study was carried out from January 1997 to December 2001 in Al Kindy Teaching Hospital.

It included 2530female patients who were admitted to the hospital with a presumptive diagnosis of acute appendicitis.

Results: The preoperative diagnosis of acute appendicitis was confirmed in 67.27% of cases; however, there was a significant number (P<0.001) of patients with gynecological disorders (23.43%).

Of these disorders, the most common was ruptured ovarian cyst (74.7%).

Most of the patients were of childbearing age.

Conclusion: In-hospital observation, repeated clinical examination, and the use of ultrasonography in all child- bearing age females presenting clinically as an acute abdomen or acute appendicitis are recommended to differentiate between surgical diseases and gynecological disorders that do not need surgical interference.