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Preoperative hormonal therapy for a patient with appendiceal endometriosis
  1. Keiko Shichiri1,
  2. Kazuhiro Nishida1,
  3. Alan Kawarai Lefor2 and
  4. Tadao Kubota1
  1. 1Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
  2. 2Surgery, Jichi Ika Daigaku, Shimotsuke, Japan
  1. Correspondence to Dr Keiko Shichiri; shichiri.k.7{at}gmail.com

Abstract

The optimal management of patients with appendiceal endometriosis has not been determined because of the difficulty of establishing a preoperative diagnosis. There are no reports of preoperative hormone therapy for a patient with appendiceal endometriosis. We report a patient who underwent resection of appendiceal endometriosis after hormone therapy. A 40-year-old woman with history of recurrent pelvic abscesses presented to the emergency department with lower abdominal pain. The recurrent pelvic abscesses were synchronised with her menstrual cycle. CT scan demonstrated a 25 mm contrast-enhanced luminal structure adjacent to the cecum, which was thought to be a mucocele of the appendix. Considering the recurrent symptoms during menstruation, endometriosis was suspected. Treatment with a gonadotropin-releasing hormone agonist was started for appendiceal endometriosis, which alleviated the symptoms. After 3 months, elective laparoscopic appendectomy was performed. Preoperative hormonal therapy is an option for patients with appendiceal endometriosis, especially when there is concern for dense adhesions.

  • reproductive medicine
  • gastrointestinal surgery
  • general surgery

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Footnotes

  • Contributors All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, writing, or revision of the manuscript. KS: concept and design of study, drafting the manuscript, approval of final manuscript. KN: participation in the treatment and perioperative management of the patient, approval of final manuscript. AKL: concept and design of study, approval of final manuscript.TK: approval of final manuscript.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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

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