ENDOMETRIOSIS AS A DIFFERENTIAL DIAGNOSIS OF ACUTE ABDOMEN

ENDOMETRIOSIS AS A DIFFERENTIAL DIAGNOSIS OF ACUTE ABDOMEN DOI: https://doi.org/10.70779/aijshs.v4i7.242Palavras-chave: Endometriosis, Acute Abdomen, Differential Diagnosis, Emergency MedicineResumo Introduction: Endometriosis is a chronic gynecological condition characterized by the presence of endometrial-like tissue outside the uterine cavity. While typically presenting with pelvic pain and infertility, it can occasionally manifest with acute abdominal symptoms. Recognizing endometriosis as a differential diagnosis in acute abdomen is crucial to avoid unnecessary surgical interventions. Objective: To explore and synthesize current evidence on the role of endometriosis as a differential diagnosis in cases of acute abdomen, focusing on diagnostic challenges, clinical presentations, imaging modalities, and surgical considerations. Methods: This narrative review included a comprehensive search of PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar for studies published between 2019 and 2025. Relevant articles addressing the emergency presentation of endometriosis, its mimickers, and its differentiation from other causes of acute abdomen were selected and analyzed. Results and Discussion: Endometriosis may mimic appendicitis, bowel obstruction, or pelvic inflammatory disease, presenting challenges in acute care settings. Laparoscopy remains the gold standard for diagnosis, although imaging techniques continue to evolve. A multidisciplinary approach enhances diagnostic accuracy and improves patient outcomes. Conclusion: Timely consideration of endometriosis in acute abdominal presentations is essential for proper diagnosis and management. Greater awareness among emergency physicians and surgeons can prevent misdiagnosis and reduce unnecessary procedures. Referências 1. Donnez J, Dolmans MM. Endometriosis and medical therapy: from progestogens to progesterone resistance to GnRH antagonists: a review. J Clin Med. 2021;10(5):1085. 2. Bendifallah S, Puchar A, Pigeau B, et al. Endometriosis-related emergencies: diagnosis and management. Diagn Interv Imaging. 2021;102(10):609-617. 3. Lazzeri L, Di Giovanni A, Exacoustos C, et al. Uterine perforation and hemoperitoneum caused by endometriosis: a diagnostic challenge. BMC Womens Health. 2020;20(1):151. 4. Abo C, Tsui B, Cohen AJ, et al. Evaluation of acute pelvic pain in the emergency department: best practices and pitfalls. Emerg Med Clin North Am. 2022;40(2):359-378. 5. Andres MP, Arcoverde FVL, Souza CC, et al. Extrapelvic endometriosis: a systematic review. J Minim Invasive Gynecol. 2020;27(2):373-389. 6. Gonçalves MO, Podgaec S, Dias JA Jr, et al. Transvaginal ultrasonography and magnetic resonance imaging for diagnosing deep endometriosis. Rev Bras Ginecol Obstet. 2021;43(10):755-761. 7. Smeets MJ, Rhemrev JP. Endometriosis of the appendix: a case report and review. Int J Surg Case Rep. 2021;82:105873. 8. Chapron C, Marcellin L, Borghese B, et al. Rethinking mechanisms, diagnosis and management of endometriosis. Nat Rev Endocrinol. 2019;15(11):666-682. 9. Khan Z, Zafar N, Khan S, et al. Role of diagnostic laparoscopy in acute abdomen. Cureus. 2020;12(6):e8726. 10. Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020;382(13):1244-1256. 11. Dunselman GA, Vermeulen N, Becker C, et al. Management of women with endometriosis: new insights and clinical practices. Obstet Gynecol Surv. 2021;76(1):30-38. 12. Kim S, Kim M, Cho JH. Appendiceal endometriosis presenting as acute appendicitis: a case report. Ann Coloproctol. 2021;37(1):53-56. 13. Moini A, Bahrami H, Kiani K, et al. Intestinal obstruction due to endometriosis: a case series and literature review. Int J Reprod Biomed. 2020;18(6):495-504. 14. Elhamid AA, El-Hady HA, Abdelbary AM. Massive hemoperitoneum from ruptured endometrioma: an uncommon acute presentation. J Obstet Gynaecol Res. 2022;48(2):452-456. 15. Evangelinakis N, Panayiotides IG, Protopapas A, et al. Ureteral endometriosis as a cause of renal loss: case report and review. Case Rep Obstet Gynecol. 2020;2020:9526240. 16. Chen M, Han Z, Wang Y, et al. Diagnostic accuracy of transvaginal ultrasonography versus MRI for deep infiltrating endometriosis. Arch Gynecol Obstet. 2020;302(6):1491-1499. 17. Bazot M, Jarboui L, Daraï E. MRI in the diagnosis and mapping of deep pelvic endometriosis: a review. J Magn Reson Imaging. 2021;53(5):1449-1460. 18. Pisanu A, Podda M, Deidda S, et al. Laparoscopy for acute abdomen in women: diagnostic and therapeutic role. World J Gastrointest Endosc. 2020;12(3):81-91. 19. Agarwal N, Subramaniam R. Laparotomy in endometriosis: surgical pitfalls in acute abdomen. Int J Gynaecol Obstet. 2021;153(2):287-289. 20. Ferrero S, Alessandri F, Racca A, et al. Pain symptomatology and treatment response in women with endometriosis-related cyclic abdominal pain. Eur J Obstet Gynecol Reprod Biol. 2022;271:90-96. 21. Capmas P, Maignien C, Fernandez H. Surgical management of endometriosis: a call for multidisciplinary care. Curr Opin Obstet Gynecol. 2021;33(4):248-253. 22. Roman H, Auber M, Vallee M, et al. Unexpected endometriosis in patients undergoing surgery for acute abdomen: incidence and clinical relevance. J Minim Invasive Gynecol. 2020;27(6):1212-1218. 23. Kan T, Suzuki Y, Ueno H, et al. Histopathological confirmation of endometriosis in acute appendicitis surgery: a retrospective review. Surg Today. 2020;50(10):1110-1114. 24. Bendifallah S, Chabbert Buffet N, Daraï E. Educational gaps in emergency diagnosis of endometriosis: a national survey. Eur J Obstet Gynecol Reprod Biol. 2022;276:168-173. 25. Moradi M, Parker M, Sneddon A, et al. Impact of delayed diagnosis of endometriosis on health-related quality of life and costs. BMC Womens Health. 2020;20(1):83. Downloads Publicado Como Citar Edição Seção Licença Copyright (c) 2025 Asclepius International Journal of Scientific Health Science Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial 4.0 International License. It is also licensed under a LOCKSS (Lots of Copies Keep Stuff Safe) sistem.