Minimum Invasive Surgery for Appendiceal Intussusception Caused by Isolated Endometriosis; Surgical Technique for an...

Area of Science:

• Gastroenterology
• Surgical Oncology
• Gynecologic Oncology

Background:

• Appendiceal intussusception is a rare condition, with endometriosis being a common cause in adults.
• Traditional surgical management often involves extensive resections like ileocecal resection or right hemicolectomy.
• This report details a unique case requiring a minimally invasive approach due to the complexity of the intussusception.

Purpose of the Study:

• To present a case of endometriosis-induced appendiceal intussusception.
• To describe a successful minimally invasive surgical technique (partial cecal resection with appendectomy).
• To highlight the feasibility of less invasive surgical options for nonreducible appendiceal intussusception.

Main Methods:

• A 47-year-old female with a 2-week history of abdominal pain underwent imaging that confirmed appendiceal intussusception with cecal involvement.
• Endoscopic reduction attempts failed, leading to a laparoscopic intervention.
• A partial cecal resection with appendectomy was performed due to the appendix being inaccessible and the intussusception being irreparable.

Main Results:

• The patient underwent a successful partial cecal resection and appendectomy.
• The patient experienced an uneventful recovery and was discharged on postoperative day two.
• Histological examination confirmed endometriosis as the cause of the appendiceal intussusception.

Conclusions:

• Endometriosis-induced Type V appendiceal intussusception can be managed with less invasive surgery, such as partial cecal resection.
• Endometriosis should be considered in the differential diagnosis of intussusception, with CA125 potentially serving as a diagnostic marker.
• Minimally invasive techniques are recommended for nonreducible appendiceal intussusception cases without malignancy, improving patient outcomes.