Advertisement

Appendiceal endometriosis invading the sigmoid colon: a rare entity

  • Panagiotis LainasEmail author
  • Carmelisa Dammaro
  • Giorgia Amy Rodda
  • Marie Morcelet
  • Sophie Prevot
  • Ibrahim Dagher
Case Report
  • 20 Downloads

Abstract

Purpose

We report an unusual case of endometriosis of the appendix with simultaneous invasion of the sigmoid colon.

Methods

Clinical, radiological, surgical, and histological data of the patient were reviewed, as well as the current literature on gastrointestinal endometriosis.

Results

A 41-year-old woman presented to the emergency department of our hospital with acute right lower quadrant pain, pronounced tenderness elevated white blood cell count, and increased C-reactive protein. Abdominal CT scan suggested a mucocele of the appendix. The patient was first treated with antibiotics, followed by en bloc resection of the appendix and of the sigmoid colon 2 months later. Histological examination revealed an endometriotic nodule of the appendix filling the appendiceal lumen and resulting in a mucocele which invaded the sigmoid colon wall.

Conclusions

The diagnosis of gastrointestinal endometriosis can be challenging due to the variety of symptoms it can produce. Although extremely rare, a concomitant double gastrointestinal location of endometriosis may be possible and should be considered in women of reproductive age.

Keywords

Endometriosis Appendix Sigmoid Appendicitis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Giudice LC (2010) Clinical practice. Endometriosis. N Engl J Med 362:2389–2398CrossRefGoogle Scholar
  2. 2.
    Tai FW, Chang CY, Chiang JH, Lin WC, Wan L (2018) Association of pelvic inflammatory disease with risk of endometriosis: a nationwide cohort study involving 141,460 individuals. J Clin Med 7.  https://doi.org/10.3390/jcm7110379
  3. 3.
    Chamie LP, Ribeiro D, Tiferes DA, Macedo Neto AC, Serafini PC (2018) Atypical sites of deeply infiltrative endometriosis: clinical characteristics and imaging findings. Radiographics 38:309–328CrossRefGoogle Scholar
  4. 4.
    Charatsi D, Koukoura O, Ntavela IG, Chintziou F, Gkorila G, Tsagkoulis M, Mikos T, Pistofidis G, Hajiioannou J, Daponte A (2018) Gastrointestinal and urinary tract endometriosis: a review on the commonest locations of extrapelvic endometriosis. Adv Med 2018:3461209CrossRefGoogle Scholar
  5. 5.
    Klingbeil KD, Azab B, Moller MG (2017) Low-grade appendiceal mucinous neoplasm and endometriosis of the appendix. World J Surg Oncol 15:226CrossRefGoogle Scholar
  6. 6.
    Gustofson RL, Kim N, Liu S, Stratton P (2006) Endometriosis and the appendix: a case series and comprehensive review of the literature. Fertil Steril 86:298–303CrossRefGoogle Scholar
  7. 7.
    Giudice LC, Kao LC (2004) Endometriosis. Lancet 364:1789–1799CrossRefGoogle Scholar
  8. 8.
    Young S, Burns MK, DiFrancesco L, Nezhat A, Nezhat C (2017) Diagnostic and treatment guidelines for gastrointestinal and genitourinary endometriosis. J Turk Ger Gynecol Assoc 18:200–209CrossRefGoogle Scholar
  9. 9.
    Burney RO, Giudice LC (2012) Pathogenesis and pathophysiology of endometriosis. Fertil Steril 98:511–519CrossRefGoogle Scholar
  10. 10.
    Sasson IE, Taylor HS (2008) Stem cells and the pathogenesis of endometriosis. Ann N Y Acad Sci 1127:106–115CrossRefGoogle Scholar
  11. 11.
    Tong YL, Chen Y, Zhu SY (2013) Ileocecal endometriosis and a diagnosis dilemma: a case report and literature review. World J Gastroenterol 19:3707–3710CrossRefGoogle Scholar
  12. 12.
    Torralba-Moron A, Urbanowicz M, Ibarrola-De Andres C, Lopez-Alonso G, Colina-Ruizdelgado F, Guerra-Vales JM (2016) Acute small bowel obstruction and small bowel perforation as a clinical debut of intestinal endometriosis: a report of four cases and review of the literature. Intern Med 55:2595–2599CrossRefGoogle Scholar
  13. 13.
    Vercellini P, Vigano P, Somigliana E, Fedele L (2014) Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol 10:261–275CrossRefGoogle Scholar
  14. 14.
    Aho AJ, Heinonen R, Lauren P (1973) Benign and malignant mucocele of the appendix. Histological types and prognosis. Acta Chir Scand 139:392–400Google Scholar
  15. 15.
    Rymer B, Forsythe RO, Husada G (2015) Mucocoele and mucinous tumours of the appendix: a review of the literature. Int J Surg 18:132–135CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Panagiotis Lainas
    • 1
    • 2
    Email author
  • Carmelisa Dammaro
    • 1
    • 2
  • Giorgia Amy Rodda
    • 1
  • Marie Morcelet
    • 3
  • Sophie Prevot
    • 2
    • 3
  • Ibrahim Dagher
    • 1
    • 2
  1. 1.Department of Minimally Invasive Digestive SurgeryAntoine-Beclere Hospital, AP-HPClamartFrance
  2. 2.Paris-Saclay UniversityOrsayFrance
  3. 3.Department of PathologyGHUPS, AP-HPLe Kremlin-BicetreFrance

Personalised recommendations