Acute Suppurative Appendicitis Research Articles

Acute Suppurative Appendicitis Following Screening Colonoscopy

Acute Suppurative Appendicitis Following Screening Colonoscopy

Analysis of the Clinical Value of Surgical Treatment and Postoperative Anti-Infection Treatment of Acute Suppurative Appendicitis

Objective: To explore the clinical value of surgical treatment and postoperative anti-infection treatment for acute suppurative appendicitis. Methods: A total of 116 patients with acute suppurative appendicitis were enrolled in this study. The collection period was from December 2021 to December 2023. The patients were randomly grouped into a control group (surgical treatment) and an observation group (surgical treatment and postoperative anti-infection treatment), of 58 patients each. At the end of the treatment, the results of each index of the two groups were compared. Results: The length of hospitalization time, exhaust time, and incidence of complications in the observation group were shorter than those of the control group (P < 0.05). The total effective rate of the observation group was higher than that of the control group (P < 0.05). Conclusion: It is crucial to perform anti-infective treatment promptly after surgical treatment in patients with acute suppurative appendicitis. It can effectively prevent the occurrence of complications and improve the clinical efficacy. Hence, it is worthy of research and promotion.

The Impact of Laparoscopic Appendectomy and Open Appendectomy on B7-H3-Mediated Intrinsic Immune Response in Children with Acute Suppurative Appendicitis.

Surgery impairs immune function and increases postoperative complications. B7H3, a co-stimulatory molecule, plays a crucial role in immune regulation. The present study examined the impact of B7H3 on the postoperative immune response in children with acute suppurative appendicitis (ASA) by comparing preoperative and postoperative B7H3 levels in laparoscopic surgery (LA) and open appendectomy (OA). 198 pediatric ASA patients were enrolled. The researcher group performed LA, while the control group performed OA. Perioperative time, recovery time of gastrointestinal function, time to pass gas, length of incision, and length of hospitalization were compared in the perioperative period. Additionally, an ELISA assay was conducted to examine the levels of inflammatory factors and B7H3 and CD28. Short-term postoperative complications were also evaluated. Compared with the control group, the research group had a short operative time, gastrointestinal function recovery time, gas time, and hospitalization time. The short-term complication rate was significantly lower in the research group. More importantly, B7H3 and CD28 were insignificantly different preoperatively, but they were all reduced postoperatively. Moreover, the reduction was more pronounced in the research group. The same results were noted in inflammatory factors and immune markers, which were non-significant different preoperatively and were typically reduced postoperatively, particularly in the research group. Finally, postoperative B7H3 was positively correlated with both inflammatory factors and immune cell levels. B7H3 was reduced in both postoperative periods, and the reduction was more pronounced in the LA group. B7H3 may be involved in postoperative recovery by modulating postoperative inflammation and immune responses.

Amyand's hernia unveiled: a case report on perforated appendix within the inguinal hernia sac

Background: Acute appendicitis (AA) is still a common cause of lower abdominal pain, which frequently leads to emergency room (ER) visits. A case of perforated appendix within the inguinal hernia sac was presented. Case presentation: The clinical journey of a 30-year-old male patient with acute right iliac fossa pain suggestive of recurrent appendicitis was detailed in this case report. The patient\'s complicated medical history, which included dostinex-treated hyperprolactinemia and a previous episode of conservatively managed appendicitis in 2017, sets the stage for complex diagnostic challenges. The patient complained of acute localized tenderness and pain in the right iliac fossa, but no gastrointestinal symptoms, fever, or diarrhea were present. The admission laboratory results showed elevated white blood cells (WBC) (15.2), hemoglobin (Hb) (15.8), and platelet (PLT) (191) levels. Computed tomography scans exposed a perforated appendix within the right inguinal hernial sac surrounded by inflammatory changes. Laparoscopic appendectomy revealed a perforated appendix within the inguinal hernial sac, necessitating omental dissection and drainage. The postoperative course was uneventful, with a 7-day hospital stay and subsequent OPD follow-up. Microscopic examination confirmed acute suppurative appendicitis with periappendicitis aligning with clinical and radiological assessments. Conclusions: Amyand\'s hernia is a rare type of hernia that involves the appendix. A perforated appendix within a groin hernia is unusual and necessitates immediate source control to manage infection and prevent sepsis.

Histopathological Study of Appendectomy Specimens in a Rural Tertiary Care Hospital in Bangladesh

Background: Appendicitis is one of the most common causes of the acute abdomen that demands emergency surgical intervention. It is a clinical condition that is frequently encountered as a diagnostic challenge. Sometimes grossly normal-appearing appendix, removed from patients with suspected acute appendicitis, on histopathological examination may reveal a more serious underlying pathology. Hence, histopathological studies form the gold standard for the diagnosis of appendicitis. Aim: To study the histopathological patterns of appendicitis in patients who underwent appendectomy. Methods: This study was carried out in the department of Pathology, Jahurul Islam Medical College, Bajitpur, Kishoreganj from January 2020 to December 2020. All the appendectomy specimens were received in 10% formalin as fixative. Sections obtained were studied to determine various histopathological patterns in appendectomy specimens. Results: A total of 252 specimens were undertaken for histopathological examination. There were 154 (61.1%) males and 98 (38.1%) females with male to female ratio of 1.6:1. The most common lesion observed was acute appendicitis (51.98%) followed by recurrent appendicitis (28.17%), acute suppurative appendicitis (07.15%), gangrenous appendicitis (06.36%), eosinophilic appendicitis (02.38%), follicular lymphoid hyperplasia (02.38%), mucinous adenoma (0.40%) and mucinous adenocarcinoma (02.38%). Conclusion: Most of the cases in this study were diagnosed with the usual features of appendicitis, though a few of them were incidental diagnoses that were missed clinically. These important incidental diagnoses undisputedly support the notion that every appendectomy specimen must be sent routinely for histopathological examination. Mediscope 2023;10(1): 17-21

腹腔镜下诊疗大网膜局灶性扭转坏死伴急性化脓性阑尾炎：1例报道及文献回顾

腹腔镜下诊疗大网膜局灶性扭转坏死伴急性化脓性阑尾炎：1例报道及文献回顾

Histopathological Spectrum of Appendicectomy Specimens with Emphasis on Unusual Findings

Introduction: The present study was carried out to assess the value of routine histopathological examination of appendectomy specimens An attempt is made to review the histopathological spectrum of appendectomy over a period of 2 years and 3 months. aims and objectives: To study the spectrum of histopathological lesions in appendectomy specimens and special emphasis is made to highlight the unusual lesions observed in surgically resected appendicectomies and appendices in medicolegal autopsies. material and methods: The study was carried out on appendectomy specimens received in the department of pathology Mahadevappa Rampure Medical College during a period of 2 years and 3 months from Jan 2019 to March 2021. Clinical data collected from records of corresponding appendectomy specimens were processed. Sections studied various histopathological patterns with an emphasis on unusual findings. results: A total of 500 specimens were analyzed among which 298 were males and 202 were females with M: F 1.4:1. The histopathological examination showed Acute appendicitis (57.4%), Acute ulcerative appendicitis (0.8%), Recurrent/Eosinophilic appendicitis (03%), Acute necrotizing appendicitis (1.6%), Acute appendicitis with periappendicitis (1.4%), Acute suppurative appendicitis (2.4%), Gangrenous appendicitis (0.8%), Healed appendicitis (2.2%), Chronic appendicitis (25.2%) and Chronic sclerosing appendicitis (1.0%). The unusual fngings were observed in 22 cases (4.4%) which include Tubercular appendicitis (1.0%), Foreign body granuloma (0.8%), Xanthogranulomatous appendicitis (0.2%), Enterobiusvermicularis (0.8%), Round worm (0.2%), Retention mucocele (0.4%), Carcinoid tumor (0.4%), Mucinous adenocarcinoma (0.4%) and Metastatic adenocarcinoma (0.2%). conclusion: Though the present study revealed usual findings of appendicitis and variants in most of the cases, the observation of unusual findings like granulomas, parasites, and neoplasms warrants a careful study of all appendectomy specimens received in the pathology department with emphasis on relevant clinical and laboratory findings thus modulating the management and follow up.

Differential expression of Chitinase 3-Like 1 protein in appendicitis and appendix carcinomas.

Chitinase 3-Like 1 (CHI3L1) has been used as an inflammatory biomarker for a variety of diseases, but its expression in acute appendicitis and appendix carcinomas remains unclear. Sixty cases of patients were studied, including 46 acute appendicitis and 14 appendix carcinomas. We divided the acute appendicitis group into acute uncomplicated appendicitis (AUA), suppurative appendicitis (SA), and gangrenous appendicitis (GA). The appendix carcinoma group was divided into appendiceal neuroendocrine neoplasms (ANENs) and appendiceal mucinous neoplasms (AMN). Controls were 32 healthy donors. Blood neutrophil to lymphocyte ratio (NLR), CHI3L1, C-reactive protein (CRP), interleukin-6 (IL-6), and serum amyloid A (SAA) were measured in the patients. Meanwhile, immunohistochemistry and immunofluorescence were used to identify the expression level and location of CHI3L1 in different cell types in appendix tissues. Compared with the controls, CHI3L1 serum levels were up-regulated in SA, GA, and AMN groups, while no significant difference was observed in the AUA and ANEN groups. Immunofluorescence revealed that CHI3L1 expression was high in macrophages and adenocarcinoma cells of appendix tissues but not in the neuroendocrine carcinoma tissues. Moreover, levels of NLR and CRP in the SA and GA groups were considerably higher than in the control group. IL-6 and SAA in SA, GA, ANENs, and AMN groups were also increased compared with the control group. In addition, CHI3L1 displayed good performance in predicting appendicitis, with an AUC of 0.862. CHI3L1 was highly expressed in acute appendicitis and appendiceal mucinous neoplasms, which can be used as a novel biomarker predicting appendicitis.

Hyperbilirubinemia and Hyponatremia as Predictors of Complicated Appendicitis.

Several studies have reported elevated serum bilirubin or reduced serum sodium levels in patients with complicated appendicitis (CA). This study examined the efficacy of hyperbilirubinemia, hyponatremia, and both combined in the preoperative diagnosis of CA. Patients who underwent surgery for acute appendicitis were included in this retrospective review. In total, 247 patients were included in the final analysis. Of these, 36 (14.2%) had early appendicitis, 177 (72.0%) had acute suppurative appendicitis, 32 (13.0%) had necrotizing/gangrenous acute appendicitis, and 2 (0.8%) had other types of appendicitis. The mean total bilirubin (TBIL) level was significantly higher in patients with CA than in those with uncomplicated appendicitis. Conversely, the mean serum sodium level was significantly lower in patients with CA than in those with uncomplicated appendicitis. The levels of TBIL (odds ratio: 1.098, 95% CI: 1.052–1.147) and serum sodium (odds ratio: 0.743, 95% CI: 0.646–0.855) were associated with CA. Hyponatremia combined with hyperbilirubinemia yielded significant discriminatory value for the diagnosis of CA. TBIL and serum sodium levels can be considered as adjuvant parameters in the diagnosis of perforated/necrotizing appendicitis. Although hyperbilirubinemia and hyponatremia together were better able to determine the risk of CA than either marker alone, other markers are required to definitively predict CA. Furthermore, large-scale studies are needed to confirm these findings.

Histopathological Evaluationof Appendectomy Specimens in a Tertiary Care Hospital

Objective: To find out the histopathological findings in appendectomy specimens, negative appendectomy rate (NAR) and the association of gender and age groups which underwent negative appendectomies in our set up.
 Study Design: Cross sectional study.
 Place and Duration of Study: POF Hospital, Wah Cantt, from Jan to Aug 2017.
 Methodology: The records of 1050 patients were assessed for the relevant clinical history, age, gender and date of their presentation in hospital. The appendectomy specimens were classified as positive specimens which contained fecoliths, worms, granulomatous inflammation, foreign body reaction, mucocele, or appendiceal tumors. All the data were entered and analyzed in SPSS-21.
 Results: Among the 1050 patients with suspicion of acute appendicitis, 458 (43.6%) were cases of acute appendicitis followed by acute suppurative appendicitis 100 (9.5%) and fecolith 79 (7.5%) in appendiceal lumen. The negative appendectomy rate was calculated as 248 (23.6%). A significant association of normal appendices was found with female gender (p=0.002) and young age group (p=0.02).
 Conclusion: Acute appendicitis was the most frequent histopathological finding in our study. The negative appendectomy rate was significantly associated with the females of young age.

Acute appendicitis: is it a seasonal disease?

Background: The aim of this study was to review the management of acute appendicitis in a rural hospital. It was generally reported to be more common in men. Appendicitis is the most common surgical cause of abdominal pain worldwide. Appendectomy is the lonely curative treatment of appendicitis.Methods: This was a retrospective study in which we reviewed the records of the patients who had been diagnosed and operated on for appendicectomy from January to December 2017 in a rural hospital. The data were analyzed with SPSS version 25.Results: The total number of the patients was 114. About 69.3% are males. The mean age was 25.11 years. About (39.5%) were above 20 years old. Most of the cases presented in the period between January and March (27.3%). Right lower quadrant pain was the most common presenting symptom (93.9%). Nausea and vomiting mentioned by 57 (50%) and 74 (64.9%) of the participants respectively, fever in 42 (36.8%), muscle guarding in 0.9%, tenderness in 44 (38.6%), abdominal ultrasound was requested in 96 (84%). The most common histological diagnosis was acute suppurative appendicitis with peri-appendicitis in 15 (13.2%). All the cases were treated with open appendicectomy.Conclusions: We concluded that male are more affected with acute appendicitis. The most common presenting symptom was right lower quadrant pain. The vast majority of the cases were in the winter. Ultrasound has been used in the most cases particularly in male more than in females. The most common histological diagnosis was acute suppurative appendicitis. Open appendicectomy is the main operative management in our pts.

Clinical Effect and Feasibility Analysis of Surgical Treatment and Postoperative Anti-infection Treatment for Acute Suppurative Appendicitis

Clinical Effect and Feasibility Analysis of Surgical Treatment and Postoperative Anti-infection Treatment for Acute Suppurative Appendicitis

Effect of Total Macroscopical Sampling of the Pediatric Appendectomy Specimen on Histopathological Diagnosis

Introduction: Acute appendicitis is considered the most common abdominal surgery in children. Pathological examination of the appendectomy specimen mainly is performed to document the presence or absence of inflammation and confirm the clinical diagnosis. If the diagnosis made by the pathologist is as ‘no appendicitis’, then clinical work up for other causes should be performed. Routine macroscopic evaluation of the appendectomy specimen consists of obtaining one section each from the base, body and the tip of the appendix and additional sections obtained from exuding or perforated areas. The aim of this study is to evaluate if the final pathological diagnosis would change when the appendectomy specimen is sampled totally. Materials and Methods: In the present study, we performed conventional macroscopical sampling from the tip, body and base of the appendix and embedded these tissues in the first two cassettes, then the rest of appendix was completely sampled in additional two to five casettes. The histopathological diagnosis of conventionally sampled tissues and the histopathological diagnosis of total macroscopical sampling were analyzed and compared. Results: A total of 87 appendectomies were evaluated, of which 58.6 % were male, and the mean age was 11.7 (1 years-18 years). The initial histopathological diagnosis was changed in 14 (16%) cases. In 8 (9.2%) cases, the initial diagnosis of reactive lymphoid hyperplasia changed to acute focal appendicitis (early appendicitis). In 4 (4.6%) cases the initial diagnosis of acute suppurative appendicitis changed to acute suppurative and perforated appendicitis, and in 2 (2.2%) cases acute perforated appendicitis changed to acute perforated and gangrenous appendicitis. Conclusion: Total macroscopical sampling of the appendectomy specimen in cases of negative appendicitis would improve the diagnosis and can document early appendicitis in pediatric cases.

Patterns of inflammatory lesions of the appendix in a Nigerian Tertiary Health Facility

Background: Appendicitis is most common between the ages of 10 and 20 years, although all ages can be affected. Acute appendicitis is the most common cause of acute surgical abdomen worldwide and its incidence varies with geographical location. The aim of this study was to review all the inflammatory lesions of the surgically removed appendix in University College Hospital, Ibadan, Nigeria and to describe the histopathological patterns of these lesions. Methods: This study was a retrospective review of all appendectomy specimens submitted to the Department of Pathology, University College Hospital, Ibadan, Nigeria from January 2009 to December 2018. Patients’ biodata, clinical parameters, and histological diagnoses were extracted from departmental surgical day books. The data were analyzed using IBM SPSS Statistics (version 23; IBM Corporation, Armonk, New York) and expressed as frequency distribution. Results: A total of 1071 appendectomy specimens were received in our laboratory during the 10-year study period, accounting for 3% of all specimens received. There were 1062 cases of inflammatory lesions, accounting for 99.2% of the cases. There was a male preponderance with male to female ratio of 1.2:1. The age was from 1 to 83 years. The most common histological diagnosis was acute suppurative appendicitis with peritonitis accounting for 47.6% of all the cases. Conclusion: The findings in our study supports the fact that acute suppurative appendicitis is the most common inflammatory disease of the appendix which is consistent with other similar studies that have been done in our environment and in the developed world.

Microvascular injury in the appendix of a pediatric patient with history of COVID-19 infection: A case report

Introduction: A novel coronavirus (SARS-CoV-2) infection has emerged in the world causing a pandemic disease with severe forms of acute respiratory failure along with other organs manifestations. Besides, frequent association with multisystem inflammatory syndrome in children (MIS-C) as complication after the recovery has been recorded. Hereby we report the histological findings in the appendix of a female pediatric patient with history of COVID-19 infection. Case Report: In our case, an 8-year-old female patient presented to the emergency department of our main tertiary hospital in Bahrain with two days history of low grade fever, lower abdominal pain, nausea, and vomiting. She was admitted to the pediatric surgical unit for a suspected acute appendicitis. A diagnostic laparoscopy and laparoscopic appendectomy was performed. The appendix was sent to the histopathology examination which confirmed the diagnosis of acute suppurative appendicitis with focal endarteritis obliterans. Retrospectively history revealed the child was COVID-19 positive three months back. Conclusion: Microvascular injury in the appendix of our case adds to the preliminary available evidences in the literature indicating that endarteritis obliterans of the gastrointestinal (GI) tract organs could be a complication of the COVID-19 virus infection like in MIS-C which is a known post-infectious complication of the virus.

Accuracy Score on Raja Isteri Pengiran Anak Saleha (RIPASA) and Pediatric Appendicitis (PAS) for Diagnosing Acute Appendicitis in Children

Abstract
 Introduction. Acute appendicitis is the most common case of acute abdomen. Diagnosis of acute appendicitis is still difficult and is one of the problems in the surgical field. The Clinical Scoring System (CSS) has been developed to help doctors classify risk categories. PAS has been widely evaluated in the pediatric population. In another study it was found that RIPASA had better sensitivity, specificity, and accuracy than PAS in pediatric patients.
 Methods. This study is a cross sectional study to assess the level of concordance between RIPASA and PAS scores in diagnosing acute appendicitis, with the gold standard of Histopathological examination. Samples were taken by consecutive method, in 30 patients aged <18 years for 1 year.
 Results. This study had an average age of 10.10 ± 3.745 years. Histopathologically early acute appendicitis 3.3%, acute suppurative appendicitis as much as 20%, acute gangrenous appendicitis 73.3% and others 3.3%. Using a cut-off point value of 9.5 for RIPASA and 7 for PAS, the sensitivity, Specificity, Accuracy of 82.75%, 100%, 80% for RIPASA, and 75.8%, 100%, 73.3% for PAS.
 Conclusion. The RIPASA score on the cut-off treshold 9.5 has better sensitivity and accuracy than PAS in diagnosing acute appendicitis in pediatric patients and can be used as CSS to assist in making decisions regarding the diagnosis of acute appendicitis in children.

Appendiceal diverticulosis, a potential mimic of low grade appendiceal mucinous neoplasm: analysis of 20 cases

Objective: To study the clinicopathologic features and the key points of differential diagnosis of appendiceal diverticulosis (AD) and low-grade mucinous neoplasm (LAMN) to avoid over-diagnosis. Methods: The clinical data, pathologic features and follow-up information of 20 patients with AD, who were diagnosed in the Peking University Third Hospital from January 2010 to November 2019 were collected and compared with 44 cases of LAMN which were diagnosed during the same period. Results: Among the 20 cases of AD, hypermucinous epithelium, filiform villi or undulating epithelium and mucosa atrophy were observed in 10 (50.0%), 4 (20.0%) and 14 (70.0%) cases, respectively, however, focally loss of lamina propria and mucosa/submucosa fibrosis were observed only in 1 (5.0%) and 4 (20.0%) cases, respectively. Extramural mucin deposits were seen in 11 (55.0%) cases, all were acellular mucin. Mucosal Schwann cell hyperplasia were present in 12 (60.0%) cases. Nine (45.0%) and 5 (25.0%) cases were associated with acute diverticulitis or acute suppurative appendicitis, respectively. In comparison with AD, LAMN cases more frequently showed hypermucinous epithelium (42/44, 95.5%), filiform villi or undulating epithelium (43/44, 97.7%), loss of lamina propria (43/44, 97.7%) and fibrosis and hyalinization of appendiceal wall (44/44, 100.0%), whereas mucosal atrophy (4/44, 9.1%) and Schwann cell hyperplasia(11/44, 25.0%) were less frequently seen (P<0.05). Follow-up information was available for 10 AD patients and 27 LAMN patients; all were alive without evidence of recurrence. Conclusions: Epithelial hyperplasia, loss of lamina propria, fibrosis of the appendiceal wall and extramural mucin deposits may occur focally in AD and should be distinguished from LAMN. The preservation of normal appendiceal mucosa architecture, lack of diffuse appendiceal wall fibrosis and hyalinization, and no definite neoplastic epithelium are the key point for preventing over-diagnosis.

Study of mast Cells in Appendectomy Specimen

Background: Mast cells play an important role in various inflammatory and immune reaction. Mast cells are constantly present in the appendices, and appendix remains one of the common surgical specimens received at pathology laboratory. Mast cells could be one of the important cell population responsible for nerve proliferation and hypertrophy in cases with clinically and histopathologically diagnosed appendicitis.&#x0D; Material and methods: The study was done on 100 surgically resected specimens of appendix received for routine histopathological evaluation at the Department of Pathology, Government Medical College, Bhavnagar, between June 2018 and May 2019. All appendices surgically resected as a therapeutic measure for clinically suspected appendicitis included. Cases of normal appendix and acute gangrenous appendicitis were excluded from the study. The appendices were assessed for their histological changes and density of mast cell infiltration. The mast cells were counted in 1% toluidine blue stained sections.&#x0D; Results: Out of 100 cases of surgically resected appendices, chronic appendicitis was found in 65% of cases and occurred frequently during the second and third decades of life. Highest mast cell count was seen in acute eosinophilic appendicitis and chronic appendicitis. No significant difference was observed in the mean mast cell counts among the different layers of the appendices studied.&#x0D; Conclusion: Mast cell counts were found to be highest in acute eosinophilic appendicitis and chronic appendicitis. Intermediate mast cell counts were seen in acute appendicitis and acute suppurative appendicitis. Mast cells appear to play roles in accentuation of inflammatory process and fibrosis.

A demographic study of a series of eosinophilic appendicitis and its correlation with the clinicopathological profile in a tertiary care hospital-a 3-year study

Introduction: Acute eosinophilic appendicitis (AEA) is a rare variant of inflammation of the appendix. The histologic hallmark of this entity is the infiltration of eosinophils in the musularis layer of the appendix with edema separating the muscle fibers with very few or no neutrophilic infiltration. A retrospective study was done to determine their demographic profile, morphological diagnosis, and clinical correlation. Materials and Methods: All cases of Acute appendicitis reported at the histopathology department of Sri Muthukumaran Medical College and Research Institute, a teaching hospital from the year of Jan 2017 to Dec 2019 were included in this study. Histopathological examination is the gold standard for the diagnosis of acute appendicitis. Hence, Formalin-fixed paraffin-embedded tissue which was stained with Hematoxylin and Eosin were retrieved and used for routine morphology and diagnosis. Results: Out of 419 cases of appendicectomies studied, 27 (6.49%) cases were found to be acute eosinophilic appendicitis, 265 (63.7%) cases were acute appendicitis, 30 (7.2%) cases were reported as acute suppurative appendicitis with periappendicitis most of which showed infiltration of eosinophils along with other inflammatory cells and 97 (23.3%) cases were reported as appendix with reactive lymphoid hyperplasia. Most of the acute appendicitis showed gross edema and congested blood vessels on the serosal surface. Enterobius vermicularis worm infestation was noted in 7 (25%) cases reported as acute eosinophilic appendicitis and in 20 (7.5%) cases of acute appendicitis. Conclusion: It was inferred that the acute eosinophilic appendicitis is a condition which could be an allergic response and an early event in the evolution of acute phlegmonous appendicitis.

Apendiks vermiformiste divertiküler hastalık ve endometriozis: Özgün bir kombinasyon

Endometriosis is characterized by the presence of endometrial glands and stroma outside the uterine cavity. Appendiceal endometriosis, which is very rare, may have nonspecific presentation such as chronic pelvic pain, but sometimes it can masquerade clinically as acute appendicitis. Also appendiceal diverticulum may be congenital or acquired and is an infrequently encountered lesion. They are often asymptomatic but when diverticulitis or perforation develops, it may clinically mimic acute abdomen of acute suppurative appendicitis. Herein we report a case with a unique combination of appendiceal diverticulosis and endometriosis in a 39-year-old woman that was diagnosed preoperatively as acute appendicitis.