Appendiceal endometriosis invading the sigmoid colon: a rare entity

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This case report describes a 41-year-old woman with rare appendiceal endometriosis that formed a mucocele and invaded the sigmoid colon, highlighting the diagnostic challenges of gastrointestinal endometriosis in reproductive-age women.

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This case report describes a 41-year-old woman who presented with acute right lower quadrant pain and was initially misdiagnosed with an appendiceal mucocele based on CT imaging. Surgical intervention revealed an endometriotic nodule within the appendix that had formed a mucocele and subsequently invaded the wall of the sigmoid colon, requiring en bloc resection of both organs. The authors highlight that gastrointestinal endometriosis can present with diverse symptoms and mimic other pathologies, making diagnosis challenging without histological confirmation. This paper is centrally about endometriosis — specifically describing a rare case of deep infiltrating endometriosis affecting the appendix and extending into the sigmoid colon.

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Abstract

PURPOSE: We report an unusual case of endometriosis of the appendix with simultaneous invasion of the sigmoid colon. METHODS: Clinical, radiological, surgical, and histological data of the patient were reviewed, as well as the current literature on gastrointestinal endometriosis. RESULTS: A 41-year-old woman presented to the emergency department of our hospital with acute right lower quadrant pain, pronounced tenderness elevated white blood cell count, and increased C-reactive protein. Abdominal CT scan suggested a mucocele of the appendix. The patient was first treated with antibiotics, followed by en bloc resection of the appendix and of the sigmoid colon 2 months later. Histological examination revealed an endometriotic nodule of the appendix filling the appendiceal lumen and resulting in a mucocele which invaded the sigmoid colon wall. CONCLUSIONS: The diagnosis of gastrointestinal endometriosis can be challenging due to the variety of symptoms it can produce. Although extremely rare, a concomitant double gastrointestinal location of endometriosis may be possible and should be considered in women of reproductive age.
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Abstract

Purpose We report an unusual case of endometriosis of the appendix with simultaneous invasion of the sigmoid colon.

Methods

Clinical, radiological, surgical, and histological data of the patient were reviewed, as well as the current literature on gastrointestinal endometriosis.

Results

A 41-year-old woman presented to the emergency department of our hospital with acute right lower quadrant pain, pronounced tenderness elevated white blood cell count, and increased C-reactive protein. Abdominal CT scan suggested a mucocele of the appendix. The patient was first treated with antibiotics, followed by en bloc resection of the appendix and of the sigmoid colon 2 months later. Histological examination revealed an endometriotic nodule of the appendix filling the appendiceal lumen and resulting in a mucocele which invaded the sigmoid colon wall.

Conclusions

The diagnosis of gastrointestinal endometriosis can be challenging due to the variety of symptoms it can produce. Although extremely rare, a concomitant double gastrointestinal location of endometriosis may be possible and should be considered in women of reproductive age. Similar content being viewed by others

References

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Condition tags

endometriosis

MeSH descriptors

Appendix Colon, Sigmoid Endometriosis Adult Appendix Appendix Colon, Sigmoid Colon, Sigmoid Endometriosis Endometriosis Female Humans Tomography, X-Ray Computed

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