A Rare Case of Endometriosis Presented as Acute Appendicitis

Background: Endometriosis is a common condition that can affect up to 15% of women of childbearing age and 2–5% of post-menopausal women. Endometriosis commonly involves the adnexa but can be present anywhere in the peritoneal cavity. Endometriosis involving the appendix is rare and preoperative diagnosis is difficult. Endometriosis of the appendix has been identified in less than 1% of patients with pelvic endometriosis. It is generally asymptomatic but may be associated with appendicitis, perforation and intussusception.

Case Presentation: A 22-year-old lady, with a regular menstrual history, presented with 5 days history of right iliac fossa pain. Examination revealed tenderness over right iliac fossa. Blood results were normal. Diagnosis of acute appendicitis is made. Open appendicectomy was performed which revealed an inflamed appendix. Histopathological examination of appendix reported as appendix endometriosis.

Conclusions: Appendiceal endometriosis affects women of childbearing age and may presents as acute appendicitis. As such, laparoscopic appendicectomy should be the gold standard for the treatment of acute appendicitis in women.