Appendiceal and bowel endometriosis mimicking acute appendicitis with small bowel obstruction: case report and brief review of the literature
Keywords:Acute appendicitis, Secondary acute appendicitis, Small bowel obstruction, Endometriosis, Acute abdominal pain
Endometriosis is defined as the presence of endometrium-like tissue outside the uterine cavity. This disease can have a variable presentation with symptoms that range from asymptomatic to non-menstrual pelvic pain, dysmenorrhea, dyspareunia, bowel symptoms, infertility, among others. We hereby present the case of a 39-year old female that presented to emergency room complaining of abdominal pain in right iliac fossa. Acute appendicitis was suspected, even though CT scan was inconclusive. Diagnostic laparoscopy was scheduled and laparoscopic appendectomy was performed and pathology examination reported acute appendicitis due to appendiceal endometriosis.
Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Eng J Med. 2020;382(13):1244-56.
Kim JH, Han E. Endometriosis and Female Pelvic Pain. Seminars Reproduct Med. 2018;36(2):143-51.
Falcone T, Flyckt R. Clinical Management of Endometriosis. Obstetr Gynecol. 2018;131(3):557-71.
Abrão MS, Dias JA, Jr Rodini GP, Podgaec S, Bassi MA, Averbach M. Endometriosis at several sites, cyclic bowel symptoms, and the likelihood of the appendix being affected. Fertil Steril. 2010;94(3):1099-1101.
Koninckx PR, Ussia A, Adamyan L, Wattiez A, Gomel V, Martin DC. Pathogenesis of endometriosis: the genetic/epigenetic theory. Fertil Steril. 2019;111(2):327-40.
Mabrouk M, Raimondo D, Mastronardi M, Raimondo I, Del Forno S, Arena A et al. Endometriosis of the Appendix: When to Predict and How to Manage-A Multivariate Analysis of 1935 Endometriosis Cases. J Minimally Invasive Gynecol. 2020;27(1):100-106.
Yeung P Jr. The laparoscopic management of endometriosis in patients with pelvic pain. Obstetr Gynecol Clin N Am. 2014;41(3):371-83.
NICE. Endometriosis: symptoms, diagnosis and management. Pharm J. 2019. Available at: https://pharmjdev.wpengine.com/article/ld/endometriosis-symptoms-diagnosis-and management. Accessed on 25 January, 2023.