¿Puede ser una apendicitis aguda la primera manifestación de endometriosis?

Arturo Cruz Cidoncha, A Robin, Asunción Aguilera Velardo, Patricia López Quindós, Marta Muñoz, Enrique González, Armando Galván Pérez, Daniel Montes, Natividad Palencia García, Luis Alberto Blázquez Hernando, Carmen Jiménez Ceinós, Miguel Ángel García Ureña
In: Progresos de Obstetricia y Ginecología · 2015 · vol. 58(9) , pp. 399–404 · doi:10.1016/j.pog.2015.04.008 · W2098294973
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This study reports on 8 patients diagnosed with appendiceal endometriosis after appendectomy, finding that acute appendicitis was the presenting symptom in 87.5% of cases.

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Abstract

Demostrar la relación entre la afectación endometriósica del apéndice cecal y el desarrollo de una apendicitis aguda. Presentamos una serie institucional de 8 pacientes con endometriosis apendicular diagnosticadas tras apendicectomía entre junio de 2009 y marzo de 2014. La media de edad fue 40,6 años, 6 en edad fértil. En 5 (62,5%) la afectación endometriósica apendicular resultó única y en 3 (37,5%) múltiple, fundamentalmente en el ovario. Siete (87,5%) iniciaron los síntomas como una apendicitis aguda. Los implantes endometriósicos afectaban la capa serosa en 6 pacientes, la capa muscular en una y la grasa periapendicular en otra. El diagnóstico de endometriosis apendicular en mujeres con apendicitis aguda solo se puede realizar tras el examen de las piezas de apendicectomía, aunque puede ser sospechado en el contexto clínico. La laparoscopia permite un diagnóstico adecuado con exploración completa de la pelvis, la apendicectomía y el tratamiento de otras lesiones. To determine the relationship between endometriotic involvement of the appendix and the development of acute appendicitis. We report a series of 8 patients with appendiceal endometriosis diagnosed after appendicectomy from June 2009 to March 2014. The mean age was 40.6 years. Six patients were of reproductive age. Endometriotic appendiceal involvement alone was found in 5 patients (62.5%) and multiorgan involvement, mainly affecting the ovary, in 3 patients (37.5%). Clinical presentation was acute appendicitis in 7 patients (87.5%). Endometriotic implants involved the serous layer in 6 patients, the muscle layer in one patient, and periappendiceal fat in another patient. Diagnosis of appendiceal endometriosis in women with acute appendicitis can only be performed after specimen study, although it may be suspected in the clinical context. Laparoscopy allows pelvic and abdominal cavity examination, appendectomy, and the treatment of other lesions.

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Condition tags

endometriosis

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References (39)

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