Abstract
Endometriosis is the presence of ectopic endometrial tissue outside the uterine cavity. It is a well-known cause of chronic pelvic pain and infertility in women. Endometriosis of the appendix is rare and may present with acute or chronic abdominal pain. Preoperative diagnosis is difficult. The definitive diagnosis is usually established following histopathological examination of the appendix. The authors report a case of ileus at the ground of adhesions formed due to appendiceal endometriosis clinically presented with recurrent attacks of abdominal pain in the eight month of pregnancy after laparoscopic removal of the ovarian endometriosis.
Highlights
Endometriosis, defined as the presence of endometrial glands and stroma outside the uterine cavity, is estimated to affect 4–50% of reproductively-aged women and results in pelvic pain and infertility in up to 50% of these patients
Gastrointestinal endometriosis is observed in 3–37% of all endometriosis cases, but appendiceal endometriosis accounts for only about 3% of gastrointestinal endometriosis and < 1% of total endometriosis cases
Endometriosis is defined as the presence of endometrial tissue outside the uterus, which induces a chronic inflammatory reaction, scaring, and formation of adhesions that may distort a woman’s pelvic anatomy [2]
Summary
Endometriosis, defined as the presence of endometrial glands and stroma outside the uterine cavity, is estimated to affect 4–50% of reproductively-aged women and results in pelvic pain and infertility in up to 50% of these patients. A 29-year-old was admitted in this hospital on February 17, 2015 in her 28th week of pregnancy, due to upper abdominal pain, after surgical and gastroenterological examination in the Emergency room of Clinical Centre of Serbia. Her last menstrual period dated back to August 3, 2014. In her personal history the patient had laparoscopic surgery due to endometriotic cyst of the left ovary, accidental lesion of the right ureter, followed by laparotomy for urological treatment During this procedure the appendix was not recognizable, so the diagnosis autodigestio appendicis endometriotica was established. A day later, the patient experienced nausea vomiting, and abdominal pain, and was administered antibiotics with ranitidine, metochlopramide, pantoprazole, fraxiparin, and i.v. fluid replacement. Postoperative course was normal, the patient was treated with antibiotics and anticoagulant therapy, and peristalsis was restored
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