Peritoneovaginal Fistula and Appendicitis-Related Pelvic Abscess in Pregnancy

M. Saleh, Mona Saleh, Antonia Francis Kim, Andrew Gardner, Andrew J. Gardner, Katherine Sun, Sara Brubaker, Sara G. Brubaker
AJP reports · 2020 · vol. 10(02) , pp. e129–e132 · doi:10.1055/s-0040-1708849 · PMID:32309013 · PMC7159981 · W3017269817
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes a pregnant woman with appendicitis, pelvic abscess, and a peritoneovaginal fistula, highlighting the diagnostic challenges and importance of physical examination in pregnancy.

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

This case report describes a second-trimester pregnant woman with acute-onset abdominal pain in whom appendicitis presented with a peritoneovaginal fistula and an associated pelvic abscess, ultimately showing isolated appendiceal endometriosis on pathology. The authors emphasize high-level diagnostic methods such as complete physical examination including speculum examination, and note that imaging criteria for appendicitis may require adjustment in pregnancy because the gravid uterus can shift apparent abscess locations. A key caveat is that, as a single case report, it cannot establish generalizable diagnostic or management outcomes beyond the described presentation. This paper is centrally about endometriosis — it documents isolated appendiceal endometriosis in a pregnancy complicated by appendicitis with a peritoneovaginal fistula and pelvic abscess.

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Abstract

Appendicitis in pregnancy is the most common nonobstetric surgical emergency. Pregnancy causes changes in anatomy, which could lead to uncertainty regarding the diagnosis of appendicitis. This case report describes a case of appendicitis presenting with peritoneovaginal fistula in a pregnant woman in the second trimester, with interesting finding of isolated appendiceal endometriosis on pathology. The importance of complete physical examination, including speculum examination, is emphasized in the pregnant patient presenting with acute-onset abdominal pain. Imaging criteria for diagnosis of appendicitis should be adjusted to account for the gravid uterus, which may cause appendiceal abscess to appear in a variety of locations, such as posterior to the cervix, as in this case.
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Abstract

Appendicitis in pregnancy is the most common nonobstetric surgical emergency. Pregnancy causes changes in anatomy, which could lead to uncertainty regarding the diagnosis of appendicitis. This case report describes a case of appendicitis presenting with peritoneovaginal fistula in a pregnant woman in the second trimester, with interesting finding of isolated appendiceal endometriosis on pathology. The importance of complete physical examination, including speculum examination, is emphasized in the pregnant patient presenting with acute-onset abdominal pain. Imaging criteria for diagnosis of appendicitis should be adjusted to account for the gravid uterus, which may cause appendiceal abscess to appear in a variety of locations, such as posterior to the cervix, as in this case. -

References

- 1 Mazze RI, Källén B. Reproductive outcome after anesthesia and operation during pregnancy: a registry study of 5405 cases. Am J Obstet Gynecol 1989; 161 (05) 1178-1185 - 2 Tamir IL, Bongard FS, Klein SR. Acute appendicitis in the pregnant patient. Am J Surg 1990; 160 (06) 571-575 , discussion 575–576 - 3 Abbasi N, Patenaude V, Abenhaim HA. Management and outcomes of acute appendicitis in pregnancy-population-based study of over 7000 cases. BJOG 2014; 121 (12) 1509-1514 - 4 McGory ML, Zingmond DS, Tillou A, Hiatt JR, Ko CY, Cryer HM. Negative appendectomy in pregnant women is associated with a substantial risk of fetal loss. J Am Coll Surg 2007; 205 (04) 534-540 - 5 ACOG Committee Opinion Number 775: non obstetric surgery during pregnancy. Obstet Gynecol 2019; 133 (04) e285-e286 - 6 Bickell NA, Aufses Jr AH, Rojas M, Bodian C. How time affects the risk of rupture in appendicitis. J Am Coll Surg 2006; 202 (03) 401-406 - 7 Guntupalli KK, Hall N, Karnad DR, Bandi V, Belfort M. Critical illness in pregnancy: part I: an approach to a pregnant patient in the ICU and common obstetric disorders. Chest 2015; 148 (04) 1093-1104 - 8 Ballard KD, Seaman HE, de Vries CS, Wright JT. Can symptomatology help in the diagnosis of endometriosis? Findings from a national case-control study--Part 1. BJOG 2008; 115 (11) 1382-1391 - 9 Shen AY, Stanes A. Isolated appendiceal endometriosis. J Obstet Gynaecol Can 2016; 38 (10) 979-981 - 10 Mabrouk M, Raimondo D, Mastronardi M. , et al. Endometriosis of the appendix: when to predict and how to manage-a multivariate analysis of 1935 endometriosis cases. J Minim Invasive Gynecol 2020; 27 (01) 100-106 - 11 Gustofson RL, Kim N, Liu S, Stratton P. Endometriosis and the appendix: a case series and comprehensive review of the literature. Fertil Steril 2006; 86 (02) 298-303 - 12 Lebastchi AH, Prieto PA, Chen C, Lui FY. Appendiceal endometriosis in a pregnant woman presenting with acute perforated appendicitis. J Surg Case Rep 2013; 2013 (12) rjt104 - 13 Nakatani Y, Hara M, Misugi K, Korehisa H. Appendiceal endometriosis in pregnancy. Report of a case with perforation and review of the literature. Acta Pathol Jpn 1987; 37 (10) 1685-1690 - 14 Giorgakis E, Karydakis V, Farghaly A. Perforated endometrial appendicitis in pregnancy. Hippokratia 2012; 16 (02) 181-183 - 15 Murphy SJ, Kaur A, Wullschleger ME. Endometrial decidualization: a rare cause of acute appendicitis during pregnancy. J Surg Case Rep 2016; 2016 (04) rjw053 - 16 Perez CM, Minimo C, Margolin G, Orris J. Appendiceal endometriosis presenting as acute appendicitis during pregnancy. Int J Gynaecol Obstet 2007; 98 (02) 164-167 - 17 Yeh D, Moyles K, Ekwenna O, Thompson WR, Neville HL, Sola JE. Spontaneous vaginal drainage of a pelvic abscess: an unusual presentation of perforated appendicitis. Pediatr Emerg Care 2009; 25 (12) 856-858 - 18 Sander S, Eliçevik M, Unal M, Vural O. An unusual presentation of appendicitis: vaginal discharge. J Pediatr Surg 2001; 36 (10) 1579-1580 - 19 Chung-Yen Chen C-FF, Chuang H-Y, Katakwar A, Chang PC. Peritoneovaginal fistula alleviated ruptured appendicitis-related pelvic abscess. E Da Med J 2017; 4 (02) 24-27

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