A Case Report of Appendiceal Intussusception by Endometriosis.

Suguru SAWADA, Makoto Ishikawa, Masahiro Sekino
In: The Japanese Journal of Gastroenterological Surgery · 1997 · vol. 30(10) , pp. 2034–2038 · doi:10.5833/jjgs.30.2034 · W2329411484
article OA: hybrid CC0 ⤵ 7 in-corpus citations
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This case report describes a 48-year-old woman with appendiceal intussusception caused by endometriosis, which presented as right lower quadrant pain and was initially suspected to be a ruptured ovarian cyst with peritonitis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper reports a case of a 48-year-old woman with right lower abdominal pain in whom ultrasound and CT suggested an ovarian cyst rupture with suspected appendicitis and generalized peritonitis, leading to emergency surgery. Intraoperatively, the authors found black-brown ascites, a ~5 cm ruptured unilocular right ovarian cystic mass, and an ileocecal area adhered to surrounding tissue where the appendix was not recognized; malignancy was suspected, prompting right salpingo-oophorectomy and right hemicolectomy. Pathology of the resected specimen diagnosed appendiceal intussusception caused by appendiceal endometriosis, noted as extremely rare among 71,000 appendectomy cases, and the authors emphasize that preoperative and intraoperative differentiation from cancer can be difficult. This paper is centrally about endometriosis — it describes appendiceal intussusception specifically caused by appendiceal endometriosis.

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Abstract

症例は48歳の女性. 右下腹部痛を訴え来院. 来院時, 右下腹部を中心に圧痛, 反跳痛, および筋性防御を認めた. 腹部超音波およびCT検査の結果, 右卵巣嚢腫および虫垂炎による汎発性腹膜炎を疑い手術を施行した. 腹腔内は黒褐色の腹水が貯留し, 右卵巣に径約5cmの壁が破裂した単房性腫瘤を認めた. 右卵巣嚢腫破裂にともなう汎発性腹膜炎と診断した. また回盲部は周囲組織と癒着し, 虫垂を認めず腫瘤を触知した. このため回盲部悪性腫瘍を疑い, 右卵巣卵管切除に加え右半結腸切除を施行した. 切除標本の病理組織検査の結果, 虫垂子宮内膜症に起因した虫垂重積と診断した. 虫垂切除71,000例中, 虫垂子宮内膜症と虫垂重積はそれぞれ0.05%, 0.01%に認められたのみである. 本症例はわれわれの調べえた範囲で本邦3例目であり, きわめてまれと思われる. 本疾患の術前診断や緊急開腹時には癌との鑑別が困難なため, 術式の選択に苦慮すると思われた.
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抄録 症例は48歳の女性. 右下腹部痛を訴え来院. 来院時, 右下腹部を中心に圧痛, 反跳痛, および筋性防御を認めた. 腹部超音波およびCT検査の結果, 右卵巣嚢腫および虫垂炎による汎発性腹膜炎を疑い手術を施行した. 腹腔内は黒褐色の腹水が貯留し, 右卵巣に径約5cmの壁が破裂した単房性腫瘤を認めた. 右卵巣嚢腫破裂にともなう汎発性腹膜炎と診断した. また回盲部は周囲組織と癒着し, 虫垂を認めず腫瘤を触知した. このため回盲部悪性腫瘍を疑い, 右卵巣卵管切除に加え右半結腸切除を施行した. 切除標本の病理組織検査の結果, 虫垂子宮内膜症に起因した虫垂重積と診断した. 虫垂切除71,000例中, 虫垂子宮内膜症と虫垂重積はそれぞれ0.05%, 0.01%に認められたのみである. 本症例はわれわれの調べえた範囲で本邦3例目であり, きわめてまれと思われる. 本疾患の術前診断や緊急開腹時には癌との鑑別が困難なため, 術式の選択に苦慮すると思われた. 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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