Appendiceal Endometriosis Mimicking Acute Appendicitis: A Case Report and Review of Literature

Fareed A. Turkey, Nadia H. Ibraheem, Sa'ad A Jabbar, Zainab Khalid Shehab Almukhtar
In: Journal of the Faculty of Medicine Baghdad · 2026 · vol. 68(2) , pp. 185–188 · doi:10.32007/jfacmedbaghdad3265 · W7166846381
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This case report describes a thirty-four-year-old female with appendiceal endometriosis mimicking acute appendicitis, highlighting the need for histopathological examination of appendectomy specimens.

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This paper reports a 34-year-old reproductive-age woman who presented with one day of acute right lower quadrant pain along with a chronic history of abdominal and recurrent pelvic pain, with clinical evaluation and laboratory findings leading to a diagnosis of acute appendicitis. She underwent laparoscopic appendectomy, and histopathology of the appendix showed endometrial glands and stroma embedded in the muscularis propria. The authors conclude that appendiceal endometriosis is a rare cause of RLQ pain that can mimic acute appendicitis, and they highlight the limitation inherent to a single case report (diagnostic uncertainty and generalizability). This paper is centrally about endometriosis — specifically appendiceal endometriosis that mimicked acute appendicitis.

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Abstract

Background: While endometriosis has a high prevalence among women during their reproductive years, appendiceal endometriosis is an uncommon clinical condition that affects women, and it is mostly presented as acute appendicitis, and or similar to several other gynecological disorders.​Case Presentation: A thirty-four years old female presented with symptoms of a one-day of acute right lower quadrant (RLQ) pain as well as a chronic history of abdominal pain and chronic recurrent pelvic pain. The physical and clinical assessment referred for laboratory, the findings suggested acute appendicitis, then admitted to Baghdad teaching hospital for Laparoscopic appendectomy, and the specimen was sent for histopathological examination, where it revealed endometrial glands and stroma embedded in the muscularis propria of the appendix.​Conclusion: Although rare, appendiceal endometriosis should be considered in the differential diagnosis of RLQ pain in reproductive-age women. This case indicates the necessity of routine histopathological examination of all appendectomy specimens to ensure accurate diagnosis and appropriate follow-up.
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Background

While endometriosis has a high prevalence among women during their reproductive years, appendiceal endometriosis is an uncommon clinical condition that affects women, and it is mostly presented as acute appendicitis, and or similar to several other gynecological disorders. Case Presentation: A thirty-four years old female presented with symptoms of a one-day of acute right lower quadrant (RLQ) pain as well as a chronic history of abdominal pain and chronic recurrent pelvic pain. The physical and clinical assessment referred for laboratory, the findings suggested acute appendicitis, then admitted to Baghdad teaching hospital for Laparoscopic appendectomy, and the specimen was sent for histopathological examination, where it revealed endometrial glands and stroma embedded in the muscularis propria of the appendix.

Conclusion

Although rare, appendiceal endometriosis should be considered in the differential diagnosis of RLQ pain in reproductive-age women. This case indicates the necessity of routine histopathological examination of all appendectomy specimens to ensure accurate diagnosis and appropriate follow-up. Received: 23 Jan. 2026, Revised:13 May 2026, Accepted: 20 May 2026, Published Online: July 2026 Published: 01 July 2026 Downloads

References

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