425 Appendicular Endometriosis- A rare presentation

Abstract

Endometriosis is a known gynaecological condition in young women of reproductive age group. It presents with many different symptom complexes, most common presentation being pain abdomen especially during menstruation. Pelvis is the most common site for endometrial deposits. Gastrointestinal endometriosis is rare. Appendicular endometriosis is rarer. There have been only a few case reports of endometriosis causing appendicitis.

We came across a case of perforation peritonitis in a young girl with a background history of endometriosis. Patient presented with sign and symptoms of acute appendicitis and on USS was found to have inflamed appendix. During diagnostic laparoscopy she was found to have gangrenous perforated appendix and a hard caecal nodule, which on histopathology revealed endometriosis. Another important fact revealed on histopathology is bleeding into the endometrial tissue. This patient underwent laparoscopic right hemicolectomy. Post – operative recovery was well and uneventful. Patient was discharged from the hospital on 5th day post operation.

We did a literature research to find out that there have been only two cases of perforated appendicitis mentioned in literature. While endometriosis is a common disease and may lead to appendicitis but it is not very common for it to present it as perforation peritonitis.