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Published on: August 24, 2019
Catamenial appendicitis
Breton F Barrier1, Shellaine R Frazier, Lisa M Brennaman
1Department of Obstetrics, Gynecology, University of Missouri, Columbia, Missouri 65212, USA. barrierb@health.missouri.edu
Background:
Reproductive-aged women undergoing appendectomy for suspected appendicitis have twice the rate of negative histology as age-matched men. The reason for this discrepancy is unknown.
Cases:
Three patients with peritoneal endometriosis and recurrent symptoms of acute appendicitis coincident with menses underwent resection of a noninflamed appendix with long-term symptom resolution. Standard pathological evaluation failed to demonstrate evidence of appendiceal endometriosis or appendicitis. Additional evaluation demonstrated a marked increase in number of mast cells in the appendiceal muscularis compared with normal appendices.
Conclusion:
The term "catamenial appendicitis" has been coined to describe these cases, and a mechanism of pathogenesis of right lower quadrant pain and nausea in patients with histologically confirmed endometriosis is proposed.
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