A Case of Endometriosis of the Appendix Presenting as Acute Appendicitis

Hideki Fujisawa, Tohru Chikenji, Masahiko Mizutani, Shin Tsuchiya, Yukio Kitsukawa

Department of Surgery, Chiba Municipal Hospital

The patient was a 44-year-old female complaining of pain and a mass in the right lower quadrant. Physical examination and laboratory data suggested acute appendicitis. Findings by medical imaginings and fiberscopy also indicated acute appendicitis. Treatment with antibiotics improved her symptoms as well as physical signs. An appendectomy was performed. The appendix (5.5 cm) was swollen and hard, especially at the tip, and spiral-shaped. Microscopic sections showed endometrial glands, stroma and hemorrage in the subseromuscular layers. The mucous layer was grossly normal. A detailed history taken after surgery revealed that she felt right lower quadrant pain without periumbilical pain, nausea or vomiting and that the symptoms occurred just after menstruation. These findings are suggestive of appendiceal endometriosis. We have to bear appendiceal endometriosis in mind when diagnosis of acute appendicitis is made.

Key words
acute appendicitis, appendiceal endometriosis

Reprint requests
Tohru Chikenji Department of Surgery, Chiba Municipal Hospital
827 Yahagi, Chiba, 280 JAPAN

Accepted
February 14, 1990

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