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Endometriosis of the appendix causing small bowel obstruction in a virgin abdomen
  1. Joseph Do Woong Choi and
  2. Michael Yunaev
  1. Department of Surgery, Norwest Private Hospital, Sydney, New South Wales, Australia
  1. Correspondence to Dr Joseph Do Woong Choi, josephchoi7{at}


A 29-year-old, otherwise well, nulligravid woman presented to the emergency department with 1-day history of generalised abdominal pain and vomiting. She had similar symptoms 6 months prior following recent menstruations, which resolved conservatively. She had no prior history of abdominal surgery or endometriosis. CT scan demonstrated distal small bowel obstruction. A congenital band adhesion was suspected, and she underwent prompt surgical intervention. During laparoscopy, a thickened appendix was adhered to a segment of distal ileum. There was blood in the pelvis. Laparoscopic adhesiolysis and appendicectomy were performed. Histopathology demonstrated multiple foci of endometriosis of the appendix with endometrial glands surrounded by endometrial stroma. Oestrogen receptor and CD10 immunostains highlighted the endometriotic foci. The patient made a good recovery and was referred to a gynaecologist for further management.

  • general surgery
  • gastrointestinal surgery

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  • Contributors JDWC and MY contributed to conception and design, acquisition of data, or analysis and interpretation of data. MY revised the article critically for important intellectual content. JDWC and MY approved the final version of the article to be published and provided agreement to be accountable for the article and ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.