A CASE OF ENDOMETRIOSIS OF THE APPENDIX

Seigo Narai, Tamekazu OTSUKA, Kimio Kondo
In: The journal of the Japanese Practical Surgeon Society · 1987 · vol. 48(12) , pp. 2051–2055 · doi:10.3919/ringe1963.48.2051 · W2323769814
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This case report describes a 39-year-old woman diagnosed with acute appendicitis who was found to have endometriosis of the appendix upon surgical exploration and histological examination.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-14 · read from full text ⓘ

This paper reports a single Japanese case of appendiceal endometriosis in a 39-year-old patient who presented with right lower quadrant pain at the ileocecal region, with muscular defense, Blumberg sign, and leukocytosis leading to a preoperative diagnosis of acute appendicitis. At laparotomy the appendix was shortened and enlarged with edematous, congestive serosa, and appendectomy was performed; the mucosa looked normal macroscopically but the wall was thickened. Histology demonstrated endometrial tissues with interstitial cells across the appendiceal lamina propria, submucosa, and muscularis propria, with marked thickening of the muscularis and no evidence of acute inflammation or malignancy. The paper is limited to this single case report, and the authors emphasize recognizing symptom overlap with acute appendicitis and assessing any relationship between abdominal pain and menstruation. This paper is centrally about endometriosis — specifically endometriosis localized to the appendix.

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Abstract

Endometriosis of the intestinal canal is a rare disease in Japan. We experienced a case of endometriosis of the appendix. The patient, aged 39 years, visited our hospital for the chief complaint of pain in the ileocecum. Since muscular defense and Blumberg sign were present in the right hypogastrium together with leucocytosis, the patient was diagnosed as having had acute appendicitis. On laparotomy the appendix was considerably shorter than usual, but had enlarged to the size of an index finger, and the serosa was edematous and congestive. Appendectomy was performed. The length of the excised appendix was 2.3cm, with a maximum diameter of 1.8cm. Although the mucous membrane appeared normal macroscopically, the appendicular wall was thickened. Histological observation revealed endometrial tissues associated with interstitial cells in the lamina propria mucosa, lamina submucosa and tunics muscularis propria of the appendix. The tunica muscularis propria was markedly thickened. There was no finding of acute inflammation or malignant change. It seems important for physicians to recognize that some cases of endometriosis of the appendix show symptoms similar to those in acute appendicitis and to carefully determine the relationship between abdominal pain and pain due to menstruation.
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A CASE OF ENDOMETRIOSIS OF THE APPENDIX 1987 Volume 48 Issue 12 Pages 2051-2055 Details Abstract Endometriosis of the intestinal canal is a rare disease in Japan. We experienced a case of endometriosis of the appendix. The patient, aged 39 years, visited our hospital for the chief complaint of pain in the ileocecum. Since muscular defense and Blumberg sign were present in the right hypogastrium together with leucocytosis, the patient was diagnosed as having had acute appendicitis. On laparotomy the appendix was considerably shorter than usual, but had enlarged to the size of an index finger, and the serosa was edematous and congestive. Appendectomy was performed. The length of the excised appendix was 2.3cm, with a maximum diameter of 1.8cm. Although the mucous membrane appeared normal macroscopically, the appendicular wall was thickened. Histological observation revealed endometrial tissues associated with interstitial cells in the lamina propria mucosa, lamina submucosa and tunics muscularis propria of the appendix. The tunica muscularis propria was markedly thickened. There was no finding of acute inflammation or malignant change. It seems important for physicians to recognize that some cases of endometriosis of the appendix show symptoms similar to those in acute appendicitis and to carefully determine the relationship between abdominal pain and pain due to menstruation. The patient, aged 39 years, visited our hospital for the chief complaint of pain in the ileocecum. Since muscular defense and Blumberg sign were present in the right hypogastrium together with leucocytosis, the patient was diagnosed as having had acute appendicitis. On laparotomy the appendix was considerably shorter than usual, but had enlarged to the size of an index finger, and the serosa was edematous and congestive. Appendectomy was performed. The length of the excised appendix was 2.3cm, with a maximum diameter of 1.8cm. Although the mucous membrane appeared normal macroscopically, the appendicular wall was thickened. Histological observation revealed endometrial tissues associated with interstitial cells in the lamina propria mucosa, lamina submucosa and tunics muscularis propria of the appendix. The tunica muscularis propria was markedly thickened. There was no finding of acute inflammation or malignant change. It seems important for physicians to recognize that some cases of endometriosis of the appendix show symptoms similar to those in acute appendicitis and to carefully determine the relationship between abdominal pain and pain due to menstruation. © Japan Surgical Association Favorites & Alerts Recently viewed articles

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endometriosis

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