ABSTRACT
Ultrasound scanning is the most commonly used investigation for evaluating a pregnant abdomen. Magnetic resonance imaging has been used in later pregnancy to exclude morbidly adherent placentae. The following conditions causing epigastric pain occur more frequently when a woman is pregnant: gastro-oesophageal reflux (GORD)/oesophagitis; biliary colic; and acute cholecystitis. Conditions incidental to pregnancy are: non-ulcer dyspepsia; gastric and duodenal ulceration; gastritis and duodenitis; irritable bowel syndrome; and acute and chronic pancreatitis. Estimates of the proportion of women who experience GORD at some time during pregnancy range from 30 to 80 per cent. Laparoscopic cholecystectomy is safe in pregnancy, although caution must be observed owing to potential pressure on the inferior vena cava as well as the increasing size of the uterus. The initial conservative management is similar to that of the non-pregnant patient. Endoscopic retrograde cholangiopancreaticogram and sphincterotomy can be performed safely in patients found to have common bile duct stones as a cause for the pancreatitis.
