Report of a Case with Appendiceal Intussusception Induced by Appendiceal Endometriosis

Yasuhiro Takeda, Toshiya Nagasaki, Hironori Fukuoka, Atsushi Ogura, Hisanori Miki, Yukiharu Hiyoshi, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Yosuke Fukunaga, Masashi Ueno
In: Nippon Daicho Komonbyo Gakkai Zasshi · 2017 · vol. 70(7) , pp. 463–468 · doi:10.3862/jcoloproctology.70.463 · W2700275209
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

A 45-year-old woman presenting with abdominal pain and bleeding was diagnosed with appendiceal intussusception due to appendiceal endometriosis after laparoscopic surgery.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-17 · read from full text ⓘ

The paper reports a 45-year-old woman with lower abdominal pain and hematochezia in whom endoscopy showed an elastic-hard, submucosal-appearing 30 mm elevation at the appendiceal orifice, and contrast CT revealed an enhancing solid mass with enlarged surrounding lymph nodes, prompting suspicion of primary appendiceal cancer or a submucosal tumor. The authors performed laparoscopic ileocecal resection for both diagnosis and treatment, finding intraoperatively that the appendiceal body protruded into the cecal lumen in an intussusception-like manner with marked shortening of the appendix. Pathology demonstrated strong fibrosis with scattered endometrial tissue from the submucosa to the muscularis propria, leading to a diagnosis of complete appendiceal intussusception caused by appendiceal endometriosis, with the authors emphasizing that preoperative diagnosis is difficult because intestinal endometriosis can mimic a submucosal tumor. This paper is centrally about endometriosis — specifically appendiceal endometriosis inducing appendiceal intussusception.

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Abstract

患者は45歳，女性，主訴は下腹部痛と下血．下部内視鏡検査で虫垂開口部に30mm径で弾性硬な粘膜下腫瘍様隆起を指摘．腹部造影CTでも同部位に造影効果を伴う充実性腫瘤を認め，原発性虫垂癌および粘膜下腫瘍を疑い，周囲リンパ節腫大もあったため診断および治療目的に腹腔鏡下回盲部切除術を施行した．切除検体の肉眼所見では虫垂体部が盲腸内腔に向かって重積様に突出し，虫垂は著明に短縮していた．病理組織学的検査で粘膜下層から固有筋層にかけて強い線維化と子宮内膜組織を散在性に認め，虫垂子宮内膜症による完全型の虫垂重積症と診断した．虫垂子宮内膜症とそれによる虫垂重積症は非常にまれであり，腸管子宮内膜症は粘膜下腫瘍様の形態をとるため術前診断は困難とされる．今回，原発性虫垂腫瘍との鑑別に苦慮し，腹腔鏡下回盲部切除術を施行した虫垂子宮内膜症による虫垂重積の1例を経験したので文献的考察を加えて報告する．
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症例報告 腹腔鏡下回盲部切除を施行した虫垂子宮内膜症による虫垂重積の1例 2017 年 70 巻 7 号 p. 463-468 詳細 抄録 患者は45歳，女性，主訴は下腹部痛と下血．下部内視鏡検査で虫垂開口部に30mm径で弾性硬な粘膜下腫瘍様隆起を指摘．腹部造影CTでも同部位に造影効果を伴う充実性腫瘤を認め，原発性虫垂癌および粘膜下腫瘍を疑い，周囲リンパ節腫大もあったため診断および治療目的に腹腔鏡下回盲部切除術を施行した．切除検体の肉眼所見では虫垂体部が盲腸内腔に向かって重積様に突出し，虫垂は著明に短縮していた．病理組織学的検査で粘膜下層から固有筋層にかけて強い線維化と子宮内膜組織を散在性に認め，虫垂子宮内膜症による完全型の虫垂重積症と診断した．虫垂子宮内膜症とそれによる虫垂重積症は非常にまれであり，腸管子宮内膜症は粘膜下腫瘍様の形態をとるため術前診断は困難とされる．今回，原発性虫垂腫瘍との鑑別に苦慮し，腹腔鏡下回盲部切除術を施行した虫垂子宮内膜症による虫垂重積の1例を経験したので文献的考察を加えて報告する． © 2017 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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