CC BY 4.0 · Journal of Coloproctology 2025; 45(01): s00451802596
DOI: 10.1055/s-0045-1802596
Case Report

Intussusception of the Cecal Appendix Secondary to Endometriosis: Case Report

1   Pontifical Catholic University of RS, Porto Alegre, RS, Brazil
,
Gabriela Pinho Fillmann
1   Pontifical Catholic University of RS, Porto Alegre, RS, Brazil
,
Marcelo Garcia Toneto
1   Pontifical Catholic University of RS, Porto Alegre, RS, Brazil
,
Lúcio Sarubbi Fillmann
1   Pontifical Catholic University of RS, Porto Alegre, RS, Brazil
,
Alessandro Batista Soares
1   Pontifical Catholic University of RS, Porto Alegre, RS, Brazil
,
Mariana Tanus Stefani
1   Pontifical Catholic University of RS, Porto Alegre, RS, Brazil
,
Marina Tonin
1   Pontifical Catholic University of RS, Porto Alegre, RS, Brazil
,
Ana Laura Avila Caumo
1   Pontifical Catholic University of RS, Porto Alegre, RS, Brazil
,
Irina Maria Ayala Lopez
1   Pontifical Catholic University of RS, Porto Alegre, RS, Brazil
› Author Affiliations
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/)

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Bibliographical Record
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