Infected endometrioma in pregnancy masquerading as acute appendicitis

Vorapong Phupong, Tassawan Rungruxsirivorn, Patou Tantbirojn, Patou Tantbírójn, Surang Triratanachat, Apichai Vasuratna
Archives of gynecology and obstetrics · 2004 · vol. 269(3) , pp. 219–220 · doi:10.1007/s00404-003-0569-7 · PMID:14676964 · W2090645440
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-07 ⓘ

An infected ovarian endometrioma in a pregnant patient, presenting with abdominal pain and leukocytosis, was surgically treated by drainage and appendectomy, confirming the diagnosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper reports a single case of a 35-year-old pregnant patient at 35 weeks with known right ovarian endometrioma who presented with right abdominal pain and diarrhea, with leukocytosis and neutrophil predominance. Although preoperative evaluation suggested acute appendicitis, exploratory laparotomy demonstrated an infected right ovarian endometrioma; the endometrioma was opened and drained and an appendectomy was performed, with confirmation by pathology. The authors note that infected endometrioma in pregnancy is rare and should be considered in the differential diagnosis of pelvic pain during pregnancy, particularly in patients with a history of ovarian endometrioma, but the work is limited to this case report. This paper is centrally about endometriosis — it describes infected ovarian endometrioma in pregnancy that mimicked acute appendicitis.

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Abstract

Background A pregnancy complicated by ovarian endometrioma is rare. Other complications of ovarian endometrioma in pregnancy, i.e., rupture and infection are also rare. Case A 35-year-old woman, gravida 2, para 0-0-1-0, at 35 weeks’ pregnancy, came to the hospital with a right abdominal pain. She also had a history of diarrhea. She had history of infertility and preexisting right endometrioma. The investigations revealed leukocytosis with neutrophils predominant. The preoperative diagnosis was acute appendicitis. Infected right ovarian endometrioma was demonstrated during exploratory laparotomy, opened and drainage of the right endometrioma and appendectomy were performed. The final diagnosis was infected ovarian endometrioma in pregnancy, later confirmed by a pathological report.

Conclusion

Although complication of ovarian endometrioma such as infected endometrioma during pregnancy is rare, it should be included in the differential diagnosis of pelvic pain during pregnancy, especially in the patient who has history of ovarian endometrioma. Similar content being viewed by others

References

Anderson M, Edmond RM (1974) Rupture of an endometriotic cyst in late pregnancy. J Obstet Gynaecol Br Commonw 81:907–909 Blanchard AC, Pastorek JG Jr, Weeks T (1987) Pelvic inflammatory disease during pregnancy. South Med J 80:1363–1365 D’Hooghe TM, Bambra CS, De Jonge I, Lauweryns JM, Raeymaekers BM, Koninckx PR (1997) The effect of pregnancy on endometriosis in baboons (Papio anubis, Papio cynocephalus). Arch Gynecol Obstet 261:15–19 Ghose AR, Vella EJ, Begg HB (1986) Bilateral salmonella salpingo-oophoritis. Postgrad Med J 62:227–228 Lipscomb GH, Ling FW, Photopulos GJ (1991) Ovarian abscess arising within an endometrioma. Obstet Gynecol 78:951–954 Loh FH, Chua SP, Khalil R, Ng SC (1998) Case report of ruptured endometriotic cyst in pregnancy treated by laparoscopic ovarian cystectomy. Singapore Med J 39:368–369 McArthur JW, Ulfelder H (1965) The effect of pregnancy upon endometriosis. Obstet Gynecol Surv 20:709–733 Rossman F, D’Ablaing G III, Marrs RP (1983) Pregnancy complicated by ruptured endometrioma. Obstet Gynecol 62:519–521 Steinberg P (1962) Endometrial cyst ruptured during pregnancy. Western J Surg 70:244–247 Vercellini P, Ferrari A, Vendola N, Carinelli SG (1992) Growth and rupture of an ovarian endometrioma in pregnancy. Int J Gynaecol Obstet 37:203–205 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Phupong, V., Rungruxsirivorn, T., Tantbirojn, P. et al. Infected endometrioma in pregnancy masquerading as acute appendicitis. Arch Gynecol Obstet 269, 219–220 (2004). https://doi.org/10.1007/s00404-003-0569-7 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-003-0569-7

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Condition tags

mesh:D004715endometrioma

MeSH descriptors

Endometriosis Ovarian Cysts Pregnancy Complications, Infectious Abdominal Pain Abdominal Pain Adult Appendicitis Appendicitis Appendicitis Cesarean Section Diagnosis, Differential Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Female Humans Infant, Newborn Laparoscopy

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