Original ArticleEndometriosis of the Appendix: When to Predict and How to Manage—A Multivariate Analysis of 1935 Endometriosis Cases
Section snippets
Materials and Methods
We conducted a retrospective cohort study on the electronic medical records of consecutive patients who underwent surgical removal for symptomatic endometriosis at our referral center between August 2004 and October 2016. The only exclusion criterion was a history of appendectomy for other pathologies. One thousand nine hundred thirty-five women were included in the study.
Before surgery, an accurate medical history was collected, and all patients underwent bimanual and speculum examinations as
Results
Fifty-one patients underwent selective appendectomy for suspected AE. No patient was preoperatively diagnosed with AE. Pathological assessment confirmed AE in 50 of 51 samples (98%). The patient with a false diagnosis at macroscopic evaluation was found to have a fecalith. The prevalence of AE in our study population was 2.6% (50/1935). The study group presented chronic inflammatory and fibrotic features in 22 women (44%), whereas acute inflammatory reactions were found in 28 women (56%). There
What Is the Prevalence of AE?
In our study, AE prevalence among patients who underwent surgery for symptomatic endometriosis was 2.6%. Several authors had studied AE prevalence in women with endometriosis or other benign gynecologic and nongynecologic diseases (ie, myomas, pelvic mass, and etc.). Tables 3 and 4 provide a summary of our data compared with 32 relevant full-text articles on this topic. The following keywords were used to conduct a computerized search of PubMed/MEDLINE: “endometriosis” AND “appendix” OR
Conclusion
Among patients with endometriosis surgically treated, AE is observed in 2.6%, and it is associated with adenomyosis, large right endometrioma, bladder endometriosis, deep posterior pelvic endometriosis, left deep lateral pelvic endometriosis, and ileocecal involvement. It is mandatory to counsel the patient with endometriosis scheduled for surgery about the risk of appendix excision and to be surgically prepared to perform selective appendectomy, especially in the presence of these risk
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MRI of endometriosis
2023, Magnetic Resonance Imaging of The Pelvis: A Practical ApproachEmergency surgery for appendectomy and incidental diagnosis of superficial peritoneal endometriosis in fertile age women
2020, Reproductive BioMedicine OnlineCitation Excerpt :In this study, the incidence was 3.3% in the overall population, which is consistent with previous reports, considering that only a subgroup of fertile age women was analysed. When investigating the prevalence of endometriosis of the appendix among women already diagnosed with endometriosis, appendiceal endometriosis was found in 2.6% of cases, if selective appendectomy (in case of gross alterations of the appendix at intra-operative evaluation or pre-operative imaging) was performed during an operation for endometriosis (Mabrouk et al., 2020). Furthermore, the application of a very detailed histopathology protocol may increase the detection of appendiceal endometriosis from 7.7% to 12.3% (Ross et al., 2020).
Occult appendix pathology in patients undergoing colorectal cancer resection and prophylactic appendectomy
2024, World Journal of SurgeryAppendectomy in endometriosis: an update on surgical indications and management of uncommon diseases
2023, Current Opinion in Obstetrics and GynecologyAppendiceal Endometriosis: A Comprehensive Review of the Literature
2023, Diagnostics
The authors declare that they have no conflict of interest.
Précis: Appendiceal endometriosis was observed in 2.6% of patients with endometriosis, especially in the presence of adenomyosis, large right endometrioma, deep pelvic lesions, and ileocecal involvement.