{"paper_id":"4fc703fb-7648-403b-9f72-b30723bb249c","body_text":"Abstract\nPurpose\nWe report an unusual case of endometriosis of the appendix with simultaneous invasion of the sigmoid colon.\nMethods\nClinical, radiological, surgical, and histological data of the patient were reviewed, as well as the current literature on gastrointestinal endometriosis.\nResults\nA 41-year-old woman presented to the emergency department of our hospital with acute right lower quadrant pain, pronounced tenderness elevated white blood cell count, and increased C-reactive protein. Abdominal CT scan suggested a mucocele of the appendix. The patient was first treated with antibiotics, followed by en bloc resection of the appendix and of the sigmoid colon 2 months later. Histological examination revealed an endometriotic nodule of the appendix filling the appendiceal lumen and resulting in a mucocele which invaded the sigmoid colon wall.\nConclusions\nThe diagnosis of gastrointestinal endometriosis can be challenging due to the variety of symptoms it can produce. Although extremely rare, a concomitant double gastrointestinal location of endometriosis may be possible and should be considered in women of reproductive age.\nSimilar content being viewed by others\nReferences\nGiudice LC (2010) Clinical practice. Endometriosis. N Engl J Med 362:2389–2398\nTai FW, Chang CY, Chiang JH, Lin WC, Wan L (2018) Association of pelvic inflammatory disease with risk of endometriosis: a nationwide cohort study involving 141,460 individuals. J Clin Med 7. https://doi.org/10.3390/jcm7110379\nChamie LP, Ribeiro D, Tiferes DA, Macedo Neto AC, Serafini PC (2018) Atypical sites of deeply infiltrative endometriosis: clinical characteristics and imaging findings. Radiographics 38:309–328\nCharatsi D, Koukoura O, Ntavela IG, Chintziou F, Gkorila G, Tsagkoulis M, Mikos T, Pistofidis G, Hajiioannou J, Daponte A (2018) Gastrointestinal and urinary tract endometriosis: a review on the commonest locations of extrapelvic endometriosis. Adv Med 2018:3461209\nKlingbeil KD, Azab B, Moller MG (2017) Low-grade appendiceal mucinous neoplasm and endometriosis of the appendix. World J Surg Oncol 15:226\nGustofson RL, Kim N, Liu S, Stratton P (2006) Endometriosis and the appendix: a case series and comprehensive review of the literature. Fertil Steril 86:298–303\nGiudice LC, Kao LC (2004) Endometriosis. Lancet 364:1789–1799\nYoung S, Burns MK, DiFrancesco L, Nezhat A, Nezhat C (2017) Diagnostic and treatment guidelines for gastrointestinal and genitourinary endometriosis. J Turk Ger Gynecol Assoc 18:200–209\nBurney RO, Giudice LC (2012) Pathogenesis and pathophysiology of endometriosis. Fertil Steril 98:511–519\nSasson IE, Taylor HS (2008) Stem cells and the pathogenesis of endometriosis. Ann N Y Acad Sci 1127:106–115\nTong YL, Chen Y, Zhu SY (2013) Ileocecal endometriosis and a diagnosis dilemma: a case report and literature review. World J Gastroenterol 19:3707–3710\nTorralba-Moron A, Urbanowicz M, Ibarrola-De Andres C, Lopez-Alonso G, Colina-Ruizdelgado F, Guerra-Vales JM (2016) Acute small bowel obstruction and small bowel perforation as a clinical debut of intestinal endometriosis: a report of four cases and review of the literature. Intern Med 55:2595–2599\nVercellini P, Vigano P, Somigliana E, Fedele L (2014) Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol 10:261–275\nAho AJ, Heinonen R, Lauren P (1973) Benign and malignant mucocele of the appendix. Histological types and prognosis. Acta Chir Scand 139:392–400\nRymer B, Forsythe RO, Husada G (2015) Mucocoele and mucinous tumours of the appendix: a review of the literature. Int J Surg 18:132–135\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nConflict of interest\nThe authors declare that they have no conflict of interest.\nAdditional information\nPublisher’s note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nLainas, P., Dammaro, C., Rodda, G.A. et al. Appendiceal endometriosis invading the sigmoid colon: a rare entity. Int J Colorectal Dis 34, 1147–1150 (2019). https://doi.org/10.1007/s00384-019-03242-0\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00384-019-03242-0","source_license":"public-domain-us","license_restricted":false}