Appendectomy in retrograde order for complete removal of endometriosis

Myong Cheol Lim, Yong Jung Song, Song YJ, Dong Ock Lee, Lee DO, Jung DC, Dae Chul Jung, Chong-Woo Yoo, Yoo CW, Sang-Yoon Park, Park SY, Sang‐Yoon Park
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2009 · vol. 25(12) , pp. 844–847 · doi:10.3109/09513590903056142 · PMID:19906005 · W2076234710
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This case report details a challenging appendectomy performed in retrograde order due to unexpected adhesions in a patient undergoing extensive endometriosis surgery.

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Abstract

Endometriosis frequently involves the intestines. Appendectomy would be often required as part of complete removal of endometriosis. We present a patient with endometriosis who required very difficult appendectomy. For complete removal of endometriosis, hysterectomy, bilateral salpingooophorectomy, low anterior resection and accompanying pelvic peritonectomy were performed through a mid-line incision. Unexpectedly, the appendiceal tip was attached to peri-hepatic tissue with the appendix adhered to the surrounding peritoneum and bowel. Completion of the appendectomy was possible in retrograde order after extension of the surgical incision above the umbilicus. Our findings suggest that preoperative image evaluation for location or position of the appendix might be helpful in patients with suspected endometriosis to offer correct counselling, obtaining adequate consent, determining the optimal surgical approach and scheduling opportune intraoperative consultation by a colorectal surgeon.

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Condition tags

endometriosis

MeSH descriptors

Appendectomy Endometriosis Gastrointestinal Diseases Ovarian Diseases Adult Endometriosis Female Gastrointestinal Diseases Humans Hysterectomy Ovarian Diseases Ovariectomy Treatment Outcome

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (9)

Cited by (2)

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License: CC0 · commercial use OK