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Case Report
A case of endometriosis of the appendix
1 Associate Lecturer, General Surgical Department, Toowoomba Hospital, University of Queensland, QLD, Australia
2 General Surgeon, Toowoomba Hospital, QLD, Australia
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Bertrand Ng Ren Joon
116 Water Street, South Toowoomba, QLD 4350,
Australia
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Article ID: 100069Z12BJ2020
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Joon BNR, Jahangiri R. A case of endometriosis of the appendix. J Case Rep Images Surg 2020;6:100069Z12BJ2020.ABSTRACT
Introduction: Endometriosis is quite common in ladies in their reproductive age, however, endometriosis of the appendix is uncommon. It is important for general surgeons to be aware of this diagnosis as incidental findings of endometriosis may occur intraoperatively during abdominal surgery to ensure timely referral to our colleagues. I present a case of endometriosis of the appendix that was diagnosed as an acute appendicitis on computed tomography (CT) scan.
Case Report: A 30-year-old lady presented with one day history of lower abdominal pain more on the right lower abdomen. She is known to have endometriosis previously. A CT scan revealed acute appendicitis with inflammatory changes in distal ileum and the appendix was slightly dilated at 6.3 mm. She also had an ultrasound that revealed a large 4 mm ovarian hypoechoic mass on her left ovary likely representing an endometrioma. She underwent a laparoscopic appendectomy and the histology result revealed two foci of endometrial present in the subserosa of the appendix with surrounding endometrial stroma seen. However, there was no acute inflammation of the appendix.
Conclusion: It is essential to be aware of the potential of endometriosis being a differential diagnosis in female of childbearing age who present with right iliac fossa. The gynecology team should be involved early especially when there is suspicion of involvement of the female reproductive organ. We would recommend surgical management of patient with symptomatic endometriosis of the appendix.
Keywords: Acute appendicitis, Appendix, Endometriosis, Laparoscopic appendectomy
SUPPORTING INFORMATION
Author Contributions
Bertrand Ng Ren Joon - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Rouzbeh Jahangiri - Substantial contributions to conception and design, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
AcknowledgmentsUniversity of Queensland, Australia.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Bertrand Ng Ren Joon et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
