A Case Report of Endometriosis of the Appendix with Appendicoduodenal Fistula.

Yoshihiro Nishida, Tomoaki Urakawa, Mitsuharu Nakamoto, Katsunori Kawaguchi, Tatsuo Sako, Takashi Kamigaki, H Haranomura, S Nakae, Sachio NISHIO, Akio Ioroi, Kiyoshi Uematsu, Yukihiro Imai
In: The Japanese Journal of Gastroenterological Surgery · 1991 · vol. 24(12) , pp. 3022–3026 · doi:10.5833/jjgs.24.3022 · W2328323196
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This case report describes a rare instance of appendiceal endometriosis with an appendicoduodenal fistula in a 68-year-old patient undergoing surgery for ascending colon cancer.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This case report describes a 68-year-old patient in Japan who was admitted for suspected ascending colon cancer and was preoperatively diagnosed (via imaging) with appendicoduodenal fistula, a right ovarian cyst, and appendiceal endometriosis involving a duodenal internal fistula. During surgery, the appendix was found to be adherent and bent toward the third portion of the duodenum with formation of the internal fistula, and the fistula opening on the duodenum was closed directly after adhesiolysis. Pathology showed glandular structures with ciliated epithelium in the subserosa of the appendix, without stromal components or hemorrhagic foci, and the condition had been asymptomatic and discovered incidentally during postoperative pathology after surgery for another disease. This paper is centrally about endometriosis — specifically appendiceal endometriosis presenting with an appendicoduodenal fistula and concurrent right ovarian involvement.

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Abstract

本邦における虫垂子宮内膜症の報告は非常に少なく, また虫垂の特発性十二指腸瘻もまれである.今回われわれは十二指腸との内瘻を伴った虫垂子宮内膜症の1例を経験したので報告する.症例は68歳.上行結腸癌にて当科入院となった. 画像診断より虫垂十二指腸瘻, 右卵巣嚢腫, 上行結腸癌の術前診断を得, 手術が施行された.虫垂は上行結腸の腸間膜側を上行し, 屈曲して十二指腸のthirdportion右下方で比較的強く線維性に癒着し, 内瘻を形成していた.手術は癒着を剥離し十二指腸の瘻孔部を直接縫合閉鎖した.病理組織学的には虫垂の漿膜下層に腺腔構造を認め, 内腔側に繊毛がみられたが, 間質成分や出血巣は認めなかった.本例は無症状に経過し, 閉経後に他疾患術後の病理学的検索にて偶然判明した, 右卵巣に同病変を伴う虫垂子宮内膜症であったが, 本症は骨盤内臓器にも併存することが多いため術前・術中の診断, 検索に留意し, 適切な手術が行われなければならないと思われた.
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抄録 本邦における虫垂子宮内膜症の報告は非常に少なく, また虫垂の特発性十二指腸瘻もまれである.今回われわれは十二指腸との内瘻を伴った虫垂子宮内膜症の1例を経験したので報告する.症例は68歳.上行結腸癌にて当科入院となった. 画像診断より虫垂十二指腸瘻, 右卵巣嚢腫, 上行結腸癌の術前診断を得, 手術が施行された.虫垂は上行結腸の腸間膜側を上行し, 屈曲して十二指腸のthirdportion右下方で比較的強く線維性に癒着し, 内瘻を形成していた.手術は癒着を剥離し十二指腸の瘻孔部を直接縫合閉鎖した.病理組織学的には虫垂の漿膜下層に腺腔構造を認め, 内腔側に繊毛がみられたが, 間質成分や出血巣は認めなかった.本例は無症状に経過し, 閉経後に他疾患術後の病理学的検索にて偶然判明した, 右卵巣に同病変を伴う虫垂子宮内膜症であったが, 本症は骨盤内臓器にも併存することが多いため術前・術中の診断, 検索に留意し, 適切な手術が行われなければならないと思われた. この記事はクリエイティブ・コモンズ [表示 - 非営利 4.0 国際]ライセンスの下に提供されています。 https://creativecommons.org/licenses/by-nc/4.0/deed.ja

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endometriosis

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