APANDİSİTİ TAKLİT EDEN İZOLE APENDİKAL ENDOMETRİOZİS OLGUSU

Abstract

Endometriozis, endometrial dokunun uterus dışında yerleşmesidir. Çoğunlukla pelviste görülürken, ekstrapelvik bölgeleri de etkileyebildiği bilinmektedir. Gastrointestinal sistem en sık etkilenen ekstrapelvik bölgedir. Nadiren apendiksi tutarak apandisiti taklit edebilir. Yazımızda, 8 aydır periyodik olarak tekrar eden sağ alt kadran ağrısı olan, çocuk doğurma çağındaki bir kadından bahsedilmektedir. Yapılan abdominal ultrasonda, apendiksin ucunda duvar kalınlaşması ve etrafında az miktarda sıvı tespit edilmiş olup distal apandisiti düşündürmüştür. Bilgisayarlı tomografide ise apendiksin ucunda yaklaşık 1 cm'lik nodüler bir kitle tespit edilmiştir. Hastanın tekrar eden şikayetleri ve tespit edilen bulgular doğrultusunda hastaya apendektomi yapılmış ve histopatolojik incelesi apendiks endometriozisi olarak raporlanmıştır. Hasta postoperatif dönemde semptomlarından kurtulmuştur. Bu olgu sunumu, sağ alt kadran ağrısına neden olabilen ve apandisiti taklit edebilen izole apendiks endometriozunu vurgulamaktadır.

Keywords

• Endometriozis
• Apendikal Endometriozis
• Apandisit
• Sağ Alt Kadran Ağrısı
• Apendektomi

THE CASE OF ISOLATED APPENDICEAL ENDOMETRIOSIS MIMICKING APPENDICITIS

Abstract

Endometriosis is the presence of endometrial tissue outside the uterine cavity. It is mostly seen in the pelvis but can also affect the extrapelvic areas of the body. Gastrointestinal (GI) tract is the most frequently affected extrapelvic site and rarely involves the appendix. When it occurs, may mimick appendicitis. We present a childbearing-age woman suffering from right lower quadrant (RLQ) pain. Her complaint was repeating cyclically for 8 months. Abdominal ultrasound (US) disclosed wall thickening at tip of the appendix and small amount of fluid around it, suggesting distal appendicitis. Computed tomography (CT) depicted approximately a 1 cm nodulary mass on tip of the appendix. Then appendectomy was performed and histopathological examination yielded appendiceal endometriosis (AE). She was recovered well and free of her symptom. This report emphasizes the isolated appendiceal endometriosis, which can cause right lower quadrant pain and mimick appendicitis.

Keywords

• Endometriosis
• Appendiceal Endometriosis
• Appendicitis
• Right Lower Quadrant Pain
• Appendectomy

References

1. 1. Gupta R, Singh AK, Farhat W, Ammar H, Azzaza M, Mizouni A, et al. Appendicular endometriosis: A case report and review of literature. Int J Surg Case Rep 2019; 64: 94-96.
2. 2. Charatsi D, Koukoura O, Ntavela IG, Chintziou F, Gkorila G, Tsagkoulis M, et al. Gastrointestinal and Urinary Tract Endometriosis: A Review on the Commonest Locations of Extrapelvic Endometriosis. Adv Med. 2018 Sep 26;2018:3461209.
3. 3. Hwang BJ, Jafferjee N, Paniz-Mondolfi A, Baer J, Cooke K, Frager D. Nongynecological Endometriosis Presenting as an Acute Abdomen. Emerg Radiol 2012 Oct; 19(5): 463-71.
4. 4. Teiga E, Radosevic A, Sánchez J, Busto M, Aguilar G, Maiques J, et al. A Rare Case of Right Lower Quadrant Pain BJR Case Rep 2018 Oct 31; 5(2): 20170024.
5. 5. Mabrouk M, Raimondo D, Mastronardi M, Raimondo I, Del Forno S, Arena A, et al. Endometriosis of the Appendix: When to Predict and How to Manage-A Multivariate Analysis of 1935 Endometriosis Cases J Minim Invasive Gynecol 2020 Jan; 27(1): 100-106.
6. 6. Unver N, Coban G, Arıcı DS, Buyukpınarbasılı N, Gucin Z, Malya FÜ, et al. Unusual Histopathological Findings in Appendectomy Specimens: A Retrospective Analysis of 2047 Cases. Int J Surg Pathol 2019 Apr; 27(2): 142-146.
7. 7. Berker B, Lashay N, Davarpanah R, Marziali M, Nezhat CH, Nezhat C. Laparoscopic Appendectomy in Patients With Endometriosis J Minim Invasive Gynecol May-Jun 2005;12(3):206-9.
8. 8. V Remorgida , N Ragni, S Ferrero, P Anserini, P Torelli, E Fulcheri. The Involvement of the Interstitial Cajal Cells and the Enteric Nervous System in Bowel Endometriosis. Hum Reprod 2005 Jan; 20(1): 264-71.

9. 9. Adeboye A, Ologun GO, Njoku D, Miner J. Endometriosis of the Vermiform Appendix Presenting as Acute Appendicitis. Cureus 2019 Oct 1; 11(10): e5816.
10. 10. Moulder JK, Siedhoff MT, Melvin KL, Jarvis EG, Hobbs KA, Garrett J. Risk of Appendiceal Endometriosis Among Women With Deep-Infiltrating Endometriosis Int J Gynaecol Obstet 2017 Nov;139(2):149-154.