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DOI: 10.1055/s-0045-1802596
Intussusception of the Cecal Appendix Secondary to Endometriosis: Case Report
Funding The author(s) received no financial support for the research.
Abstract
Introduction
Appendicular intussusception is the invagination of the appendix into the cecum. Endometriosis is the presence of endometrial tissue outside the uterine cavity, and it has a variable clinical picture, presenting as acute appendicitis or intestinal obstruction due to intussusception. The aim of the present paper is to report a case of cecal appendix intussusception secondary to endometriosis, since this is an extremely rare condition and there are few studies on the subject in the literature.
Case Report
We herein report the case of a 37-year-old female patient with deep endometriosis and abdominal pain in the right iliac fossa associated with menstruation. There was an intraluminal formation in the cecum, in the appendicular ostium. Magnetic resonance imaging showed foci compatible with ectopic endometrium in the uterus, rectum, and sigmoid colon. The cecal appendix was enlarged. Resection of the terminal ileum and cecum was performed, and the surgical specimen led to the diagnosis of appendicular intussusception and endometriosis of the cecal appendix.
Discussion
In adults, the most common etiologies of appendicular intussusception are endometriosis, mucocele, carcinoid tumors, and adenocarcinomas. In patients with endometriosis, involvement of the cecal appendix is infrequent. The definitive diagnosis is established by analyzing the surgical specimen, and imaging tests play a limited role in ruling out malignancies. Laparoscopic cecectomy is usually chosen, preserving the ileocecal valve. Hormone suppression therapy can prevent the recurrence of intestinal endometriosis.
Conclusion
Appendicular intussusception, although an infrequent pathology, is an occurrence that requires surgical treatment and, in patients with endometriosis, it is important to include this hypothesis in the differential diagnosis.
Authors' Contributions
Sofia Marasca Giongo was responsible for analyzing and interpreting all data, as well as contributing to the design of the study. Gabriela Pinho Fillmann was involved in the analysis and interpretation of data, as well as in writing the manuscript. Marcelo Garcia Toneto and Lúcio Sarubbi Fillmann supervised the manuscript and conducted the final review. Alessandro Batista Soares, Mariana Tanus Stefani, Marina Tonin and Ana Laura Avila Caumo contributed by analyzing and interpreting the data and assisting in writing the manuscript. Irina Maria Ayala Lopez analyzed the images used in the article.
Publication History
Received: 13 August 2024
Accepted: 25 November 2024
Article published online:
20 March 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil
Sofia Marasca Giongo, Gabriela Pinho Fillmann, Marcelo Garcia Toneto, Lúcio Sarubbi Fillmann, Alessandro Batista Soares, Mariana Tanus Stefani, Marina Tonin, Ana Laura Avila Caumo, Irina Maria Ayala Lopez. Intussusception of the Cecal Appendix Secondary to Endometriosis: Case Report. Journal of Coloproctology 2025; 45: s00451802596.
DOI: 10.1055/s-0045-1802596
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