A Case of Appendiceal Endometriosis in a Menopausal Woman

Takashi Shibata, K Tohara, Sigeru Wada, Yasue Uchida, Thuanny Fernandes Brito Noguchi, Kazuya Kawahara
In: Nippon Daicho Komonbyo Gakkai Zasshi · 2007 · vol. 60(2) , pp. 89–94 · doi:10.3862/jcoloproctology.60.89 · W2011687763
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This report details a case of appendiceal endometriosis in a postmenopausal woman presenting with lower abdominal pain, diagnosed after surgery for suspected appendicitis and pelvic abscess.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

The paper reports a 57-year-old menopausal woman who underwent emergency surgery for suspected perforated appendicitis and a pelvic abscess, presenting with lower abdominal pain, urinary frequency, elevated white blood cell count, and elevated CRP; imaging suggested an appendiceal perforation with abscess. Intraoperatively, the appendix had enlargement of the distal half, was adherent to the retroperitoneal side, and had an abscess at the distal portion. Histopathology showed no inflammation in the appendiceal mucosa, but endometrial tissue within the muscular layer of the serosal side, leading to a diagnosis of appendiceal endometriosis. The authors emphasize that preoperative diagnosis of appendiceal endometriosis is extremely difficult and that detailed postoperative pathological examination is important. This paper is centrally about endometriosis—specifically appendiceal endometriosis presenting as suspected perforated appendicitis in a menopausal woman.

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Abstract

今回我々は, 虫垂炎を疑い手術を施行した閉経後虫垂子宮内膜症を経験したので報告する.症例は57歳の女性, 主訴は下腹部痛であった. 右下腹部を中心に圧痛をみとめ, Blumberg徴候陽性であった. また, 頻尿を認めた. 血液検査で白血球数の増加およびCRP値の上昇認め, 腹部超音波検査, 腹部骨盤CT検査で虫垂穿孔性の骨盤膿瘍が疑われた. 穿孔性虫垂炎および骨盤内膿瘍の診断にて, 緊急手術を施行した.手術所見では虫垂は末梢側約1/2が腫大し, 後腹膜側に癒着しており, 虫垂末梢側に膿瘍を認めた. 切除標本の病理組織学所見では虫垂粘膜に炎症は認められず, 虫垂の漿膜側の筋層内に子宮内膜を認め, 虫垂子宮内膜症と診断した.虫垂子宮内膜症は術前診断が極めて困難であり, 術後の詳細な病理学的検索が重要であると考えられた.
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症例報告 急性虫垂炎として切除した閉経後虫垂子宮内膜症の1例 2007 年 60 巻 2 号 p. 89-94 詳細 抄録 今回我々は, 虫垂炎を疑い手術を施行した閉経後虫垂子宮内膜症を経験したので報告する. 症例は57歳の女性, 主訴は下腹部痛であった. 右下腹部を中心に圧痛をみとめ, Blumberg徴候陽性であった. また, 頻尿を認めた. 血液検査で白血球数の増加およびCRP値の上昇認め, 腹部超音波検査, 腹部骨盤CT検査で虫垂穿孔性の骨盤膿瘍が疑われた. 穿孔性虫垂炎および骨盤内膿瘍の診断にて, 緊急手術を施行した. 手術所見では虫垂は末梢側約1/2が腫大し, 後腹膜側に癒着しており, 虫垂末梢側に膿瘍を認めた. 切除標本の病理組織学所見では虫垂粘膜に炎症は認められず, 虫垂の漿膜側の筋層内に子宮内膜を認め, 虫垂子宮内膜症と診断した. 虫垂子宮内膜症は術前診断が極めて困難であり, 術後の詳細な病理学的検索が重要であると考えられた. 症例は57歳の女性, 主訴は下腹部痛であった. 右下腹部を中心に圧痛をみとめ, Blumberg徴候陽性であった. また, 頻尿を認めた. 血液検査で白血球数の増加およびCRP値の上昇認め, 腹部超音波検査, 腹部骨盤CT検査で虫垂穿孔性の骨盤膿瘍が疑われた. 穿孔性虫垂炎および骨盤内膿瘍の診断にて, 緊急手術を施行した. 手術所見では虫垂は末梢側約1/2が腫大し, 後腹膜側に癒着しており, 虫垂末梢側に膿瘍を認めた. 切除標本の病理組織学所見では虫垂粘膜に炎症は認められず, 虫垂の漿膜側の筋層内に子宮内膜を認め, 虫垂子宮内膜症と診断した. 虫垂子宮内膜症は術前診断が極めて困難であり, 術後の詳細な病理学的検索が重要であると考えられた. © 2007 日本大腸肛門病学会 この記事はクリエイティブ・コモンズ [表示 - 非営利 - 改変禁止 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-nd/4.0/deed.ja

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endometriosis

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