Catamenial Appendicitis

Breton F. Barrier, Barrier BF, Frazier SR, Shellaine R. Frazier, Lisa M Brennaman, Brennaman LM, Jessica C. Taylor, Taylor JC, Bruce Ramshaw, Ramshaw BJ, Bruce J Ramshaw
Obstetrics and gynecology · 2008 · vol. 111(2) , pp. 558–561 · doi:10.1097/01.aog.0000286770.79766.95 · PMID:18239022 · W4253197183
article OA: closed CC0 ⤵ 6 in-corpus citations
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

Three women with recurrent appendicitis-like symptoms coinciding with menses showed symptom resolution after appendectomy, revealing increased mast cells in the muscularis and proposing the term "catamenial appendicitis."

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-21 · read from full text ⓘ

This case series describes three reproductive-aged women with peritoneal endometriosis who experienced recurrent acute appendicitis symptoms synchronized with their menstrual cycles. Although standard pathological evaluation revealed no evidence of appendiceal inflammation or endometriosis within the appendix tissue, further analysis identified a significant increase in mast cells within the appendiceal muscularis layer compared to normal controls. The authors propose that this mast cell proliferation may underlie the pathogenesis of right lower quadrant pain and nausea in these patients, leading them to coin the term "catamenial appendicitis." This paper is centrally about endometriosis — specifically describing a novel clinical presentation where peritoneal endometriosis causes cyclic appendiceal-like symptoms without histological evidence of appendicitis or direct endometrial implantation in the appendix.

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Abstract

BACKGROUND: Reproductive-aged women undergoing appendectomy for suspected appendicitis have twice the rate of negative histology as age-matched men. The reason for this discrepancy is unknown. CASES: Three patients with peritoneal endometriosis and recurrent symptoms of acute appendicitis coincident with menses underwent resection of a noninflamed appendix with long-term symptom resolution. Standard pathological evaluation failed to demonstrate evidence of appendiceal endometriosis or appendicitis. Additional evaluation demonstrated a marked increase in number of mast cells in the appendiceal muscularis compared with normal appendices. CONCLUSION: The term "catamenial appendicitis" has been coined to describe these cases, and a mechanism of pathogenesis of right lower quadrant pain and nausea in patients with histologically confirmed endometriosis is proposed.
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Background

Reproductive-aged women undergoing appendectomy for suspected appendicitis have twice the rate of negative histology as age-matched men. The reason for this discrepancy is unknown. CASES: Three patients with peritoneal endometriosis and recurrent symptoms of acute appendicitis coincident with menses underwent resection of a noninflamed appendix with long-term symptom resolution. Standard pathological evaluation failed to demonstrate evidence of appendiceal endometriosis or appendicitis. Additional evaluation demonstrated a marked increase in number of mast cells in the appendiceal muscularis compared with normal appendices.

Conclusion

The term “catamenial appendicitis” has been coined to describe these cases, and a mechanism of pathogenesis of right lower quadrant pain and nausea in patients with histologically confirmed endometriosis is proposed.

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Condition tags

endometriosis

MeSH descriptors

Abdominal Pain Abdominal Pain Appendectomy Appendix Endometriosis Peritoneal Diseases Abdominal Pain Adolescent Adult Appendix Endometriosis Endometriosis Female Humans Peritoneal Diseases Peritoneal Diseases

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (7)

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