EP 439 Acute Appendicitis as the First Presentation of Endometriosis: A Case Report
Rakhitha Katangodage, Imad-ud-din Saqib, Thanika Thillaivasan, Manoj Jacob, Julian SturtAbstract
Introduction
Appendiceal endometriosis is a rare condition characterised by inflammation of the appendix secondary to the presence of endometrial tissue resulting in presentation with symptoms of acute appendicitis. This is usually confirmed postoperatively on histopathological analysis as there is no notable difference macroscopically. The usual management involves appendicectomy based on the presenting diagnosis of acute appendicitis.
Case
We describe the case of a previously fit and well 34-year-old woman who presented to the Emergency Department with right iliac fossa pain, nausea, vomiting and elevated inflammatory markers. She did not have any previous history of gynaecological conditions. Cross sectional imaging demonstrated acute appendicitis for which she underwent laparoscopic appendicectomy and remained well postoperatively with no complications. She was then referred to gynaecology following histopathological diagnosis of appendiceal endometriosis for further management.
Conclusion
Appendiceal endometriosis may be a harbinger of endometrial disease in young previously undiagnosed female patients. Timely involvement of the gynaecology team on diagnosis could reduce patient concerns regarding any new abdominal symptoms postoperatively.