Clinical case report: Acute appendicitis due to appendicular endometriosis.
DOI:
https://doi.org/10.31243/mdc.uta.v9i2.2837.2025Keywords:
Acute appendicitis, appendiceal endometriosisAbstract
Appendiceal Endometriosis is a rare condition that occurs in women of reproductive age. It can present as an acute inflammatory abdomen, where the expertise of the healthcare professional and the performance of a thorough physical examination play a crucial role in determining whether surgical intervention is necessary. This article reports a case of acute appendicitis due to appendiceal endometriosis with a subhepatic location of the vermiform appendix.
Objective: To describe a clinical case of appendiceal endometriosis in a patient presenting with an acute appendicitis-like clinical picture, with an unusual location, along with its management, clinical evolution, and the identification of the most appropriate surgical technique.
Materials and Methods: This is a descriptive retrospective case report. Informed consent was obtained from the patient for the review of her medical records and imaging studies, which contributed to the development of this investigation. Bibliographic references published up to August 2024 were included.
Results: We report the case of a 30-year-old female patient who presented to the emergency department with a clinical picture initially compatible with Pelvic Inflammatory Disease, which did not respond to medical treatment. Due to the persistence of an acute inflammatory abdomen, a diagnostic laparoscopy was performed, revealing a Grade I appendix located in the subhepatic region.
Conclusion: Appendiceal endometriosis is caused by subserosal or subperitoneal invasion. Its prevalence ranges from 0.05% to 1.69%, making it a rare entity. Even more uncommon is the subhepatic location of the cecum and appendix, with an incidence of 0.09 per 100,000 population. Subhepatic appendicitis is difficult to diagnose, as it may mimic hepatobiliary diseases, making the decision for surgical intervention challenging. The surgeon’s experience and training, along with preoperative imaging and careful planning, are fundamental pillars for the successful evaluation and surgical management of this condition
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Copyright (c) 2025 David Aulestia, Edwin Alarcón, Steven Alarcón , Evelyn Salguero, Jenifer Salguero
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