Gallo AB, Zanella CLP, Gallo CB, Hidalgo VC, Aguirre TJ, Andrade AB

Language: Spanish
References: 7
Page: 61-63
PDF size: 157.28 Kb.

ABSTRACT

Introduction: Endometriosis is a common disease, characterized by endometrial tissue outside the uterus. It represents 3% of cases with gastrointestinal affection and < 1% of all cases of endometriosis. Case report: A 27 years old female, admitted in emergency due to abdominal pain in the right lower quadrant with 12 hours evolution; associated to nausea and vomiting on one occasion and three diarrheal stools. On physical: cardiac frequency 90/min; TA 120/80 mmHg; RF 18 min; afebrile; abdomen with peristalsis present, severe pain in right lower quadrant, positives signs of McBurney, Rovsing, Von Blumberg and Psoas. Laboratory studies reported leukocytosis of 11,800 with 87% segmented; ultrasound study was suggestive of acute appendiceal process, appendix of 6.6 mm in its transverse diameter and presence of peri-appendicular nodes. Laparoscopic appendectomy was performed, pathology reported a local acute peri-appendicitis secondary to appendiceal endometriosis with multiple foci at the level of the muscle layer and subserosa. Conclusions: Endometriosis affects the cecal appendix in 3% of cases, so this diagnostic must be present in the differential diagnosis of cases with acute abdomen.

REFERENCES

1. Zondervan KT, Becker CM, Koga K, Missmer SA, Taylor RN, Viganò P. Endometriosis. Nat Rev Dis Primers. 2018; 4 (1): 9. doi: org/10.1038/s41572-018-0008-5.

2. Dunselman GA, Vermeulen N, Becker C, Calhaz-Jorge C, D’Hooghe T, De Bie B et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014; 29 (3): 400-412.

3. Reyna-Villasmil E, Torres-Cepeda D, Labarca-Acosta M. Endometriosis del apéndice. Gastroenterol Hepatol. 2016; 39 (7): 463-465.

4. Emre A, Akbulut S, Yilmaz M, Bozdag Z. An unusual cause of acute appendicitis: appendiceal endometriosis. Int J Surg Case Rep. 2013; 4 (1): 54-57.

5. Laskou S, Papavramidis TS, Cheva A, Michalopoulos N, Koulouris C, Kesisoglou I et al. Acute appendicitis caused by endometriosis: a case report. J Med Case Reps. 2011; 5: 144-146.

6. Ayala RS, Grández UJ, Fernández LJ, Domínguez ML, Castañeda AD, Huamán GM. Endometriosis apendicular: a propósito de un caso. Acta Med Per. 2010; 27: 127-128.

7. Yoon J, Lee YS, Chang HS, Park CS. Endometriosis of the appendix. Ann Surg Treat Res. 2014; 87 (3): 144-147.