Endometriosis and the appendix: a case series and comprehensive review of the literature

R.L. Gustofson, Gustofson RL, Robert L Gustofson, Nancy Kim, Kim N, Shannon Liu, Liu S, Stratton P, Pamela Stratton
Fertility and sterility · 2006 · vol. 86(2) , pp. 298–303 · doi:10.1016/j.fertnstert.2005.12.076 · PMID:16828481 · W2063365807
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This case series and literature review examines the relationship between endometriosis and the appendix, presenting findings on their association and management.

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Abstract

OBJECTIVE: To report the prevalence of appendiceal disease in women with chronic pelvic pain undergoing laparoscopy for possible endometriosis, summarize the literature, and more accurately estimate the prevalence of endometriosis of the appendix. DESIGN: Prospective case series and literature review. SETTING: Academic research institute. PATIENT(S): One hundred thirty-three patients with chronic pelvic pain and possible endometriosis undergoing laparoscopy. INTERVENTION(S): History, physical exam, and abdominopelvic laparoscopy. Endometriosis and adhesions were excised using selective Nd:YAG contact laser trabeculoplasty and pathologically evaluated. Only patients with visible abnormalities involving the appendix were treated via concurrent laparoscopic appendectomy. MAIN OUTCOME MEASURE(S): Appendiceal abnormalities at laparoscopy. RESULT(S): Of 133 patients, 13 had a previous appendectomy with unknown pathology. Of the remaining 120 patients, 109 reported right lower quadrant pain. Of this subgroup, six patients had appendiceal pathology: four with pathology-confirmed endometriosis, one with Crohn's disease suspected at laparoscopy, and one with chronic appendicitis. The prevalence of appendiceal endometriosis in patients with biopsy-proven endometriosis (n = 97) or with right lower quadrant pain (n = 109) was 4.1% and 3.7%, respectively. This rate was similar to the 2.8% prevalence confirmed by literature review in patients with endometriosis but was much higher than that reported in all patients (0.4%). CONCLUSION(S): Appendiceal endometriosis, while relatively uncommon in patients with endometriosis, is rare in the general population. In patients with right lower quadrant or pelvic pain, the appendix should be inspected for endometriosis and evidence of nongynecologic disease.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Appendix Appendix Cecal Diseases Cecal Diseases Endometriosis Endometriosis Pelvic Pain Adult Adult Appendectomy Appendectomy Appendectomy Appendicitis Appendicitis Appendicitis Cecal Diseases Cecal Diseases Cecal Diseases Chronic Disease Chronic Disease

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (62)

Cited by (50)

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License: CC0 · commercial use OK