Appendiceal Disease in Women with Endometriosis and Right Lower Quadrant Pain

R. Harris, Harris RS, R S Harris, W G Foster, Warren G. Foster, Foster WG, Surrey MW, M W Surrey, M. Surrey, Sanjay K. Agarwal, S K Agarwal
The Journal of the American Association of Gynecologic Laparoscopists · 2001 · vol. 8(4) , pp. 536–541 · doi:10.1016/s1074-3804(05)60617-2 · PMID:11677333 · W2107455470
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This paper investigated appendiceal disease in women presenting with right lower quadrant pain and endometriosis, examining the prevalence and characteristics of appendiceal pathologies in this specific patient group.

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Abstract

Study objectiveTo evaluate the frequency and range of appendiceal disease in women with endometriosis and right lower quadrant (RLQ) pain, and to estimate the value of preoperative gastrograffin enema (GGE) as a screen for the disease.DesignNonrandomized clinical trial (Canadian Task Force classification II-2).SettingUniversity-affiliated hospital with a private practice setting.PatientsA subpopulation of 65 women from a group of 337 patients undergoing laparoscopy for symptomatic endometriosis.InterventionPreoperative GGE was performed whenever possible in these women. At laparoscopy, the appendix was removed if it appeared abnormal or if the preoperative GGE was positive.Measurements and main resultsOf 65 women (19%) with symptomatic endometriosis and preoperative RLQ pain, 52 (80%) underwent appendectomy as part of surgery. Of these 52 excised appendixes, 39 (75%) had histologically confirmed pathology including appendicitis or periappendicitis, endometriosis, fibrous obliteration, lymphoid hyperplasia, and carcinoid tumor. Preoperative GGE had sensitivity of 74% and specificity of 83% for appendiceal disease. Its positive predictive value was 95% and negative predictive value was 42%. No complications from laparoscopic appendectomy occurred.ConclusionDisease of the appendix is common in women with endometriosis and RLQ pain. Appendectomy is particularly likely if preoperative GGE is positive.

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Condition tags

endometriosis

MeSH descriptors

Abdominal Pain Appendicitis Endometriosis Abdominal Pain Abdominal Pain Abdominal Pain Adolescent Adult Appendicitis Appendicitis Appendicitis Biopsy, Needle Cohort Studies Comorbidity Diatrizoate Meglumine Endometriosis Endometriosis Endometriosis Enema Female

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References (14)

Cited by (25)

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