[Deciduosis causing perforating appendicitis in the early postpartum period following caesarean section].

Area of Science:

• Gynecology and Obstetrics
• Gastroenterology
• Surgical Pathology

Background:

• Deciduosis, the presence of ectopic decidual tissue, can occur in various abdominal locations during pregnancy.
• Appendiceal deciduosis is an exceptionally rare condition, often presenting with symptoms mimicking acute appendicitis.
• Caesarean section is a common obstetric procedure, and its potential association with intra-abdominal ectopic decidua warrants consideration.

Observation:

• A 29-year-old primigravida developed acute abdomen with appendicitis signs on postoperative day 5 after a caesarean section for intrauterine fetal distress.
• Emergency laparotomy revealed a perforated appendix with gangrenous inflammation.
• Histological examination of the resected appendix confirmed deciduosis involving all intestinal wall layers.

Findings:

• The appendix was perforated and gangrenous, necessitating appendicectomy.
• Microscopic analysis confirmed deciduosis, a rare finding in the appendix.
• This represents the first Hungarian report of appendiceal deciduosis and the first international report of appendicectomy for this condition post-caesarean section.

Implications:

• Appendiceal deciduosis should be considered in the differential diagnosis of acute abdomen in postpartum women, especially after caesarean section.
• Prompt surgical intervention is crucial for managing complications like perforation and gangrene.
• Understanding the etiology and clinical presentation of deciduosis is vital for accurate diagnosis and effective patient management.