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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
Obstetrics and Gynecology
|February 2, 2008
Summary
Women with endometriosis may experience "catamenial appendicitis," characterized by recurrent appendicitis symptoms linked to their menstrual cycle. Increased mast cells in the appendix suggest a potential cause for this condition.
Area of Science:
- Gynecologic pathology
- Surgical pathology
- Gastroenterology
Background:
- Women of reproductive age have a higher rate of negative appendectomy findings compared to men.
- The underlying cause for this discrepancy in suspected appendicitis cases remains unclear.
Observation:
- Three women with endometriosis experienced recurrent appendicitis-like symptoms coinciding with menstruation.
- Appendectomy resolved symptoms, but standard pathology showed no appendicitis or endometriosis in the appendix.
- Further analysis revealed significantly elevated mast cell counts in the appendiceal muscularis of these patients.
Findings:
- The study identified a potential link between endometriosis and appendiceal symptoms, termed 'catamenial appendicitis'.
- Elevated mast cell infiltration in the appendix appears to be a key pathological finding.
- This suggests a mechanism for cyclical right lower quadrant pain and nausea in women with endometriosis.
Implications:
- This research may lead to improved diagnostic criteria for appendicitis in women with endometriosis.
- Understanding catamenial appendicitis could refine surgical decision-making and patient management.
- Further investigation into mast cell involvement may reveal novel therapeutic targets for endometriosis-related pain.
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