[Endometriosis of the appendix presenting like acute appendicitis--a case report]

Area of Science:

• Gastroenterology
• Gynecology
• Surgical Pathology

Background:

• Lower right abdominal pain is a common surgical admission, often due to acute appendicitis.
• Appendectomy is the standard treatment for acute appendicitis.
• Differential diagnosis requires considering long-term symptoms that may be masked by acute exacerbation.

Observation:

• A 38-year-old female presented with lower right abdominal pain, initially diagnosed as acute appendicitis.
• Intraoperative findings included hemorrhagic peritoneal fluid, nodularity of the appendix, terminal ileum edema, and an adnexal tumor.
• Histological evaluation revealed appendiceal endometriosis, endometrial mass in the terminal intestine, and ovarian endometriosis.

Findings:

• Appendiceal endometriosis is challenging to diagnose preoperatively.
• Endometriosis should be considered in fertile women with chronic abdominal pain and gynecological history.
• Laparoscopy is recommended for diagnosis and treatment, followed by histopathological confirmation.

Implications:

• This case highlights the importance of considering endometriosis in the differential diagnosis of acute abdominal pain.
• Prompt gynecological assessment and follow-up are crucial after surgical management.
• Early diagnosis and treatment of appendiceal endometriosis can prevent complications and improve patient outcomes.