Objective:To analyze the clinical and pathological characteristics of appendiceal endometriosis.Methods:A retro-spective analysis was conducted on clinical data of 14 patients with pathologically confirmed appendiceal endometriosis diagnosed from Aug.2005 to Apr.2022.Results:The median age of patients diagnosed with appendiceal endometriosis was 43.5(35.0,46.0)years,with 7.1%(1 case)below the age of 30,28.6%(4 cases)aged 30-40,50.0%(7 cases)aged 40-50,and 14.3%(2 cases)above the ageof50.Amongthe patients,64.3%(9 cases)experienced dysmenorrhea before surgery,and their dysmenorrhea symptoms were relieved after surgery.Pathological examination confirmed the presence of acute or chronic inflammation in 85.7%(12 cases)of the patients.Clinical diagnoses of primary infertility were made in 28.6%(4 cases)of the patients.Preoperative examinations did not suggest appendiceal endometriosis in any of the patients,and the diagnosis was made based on postoperative pathology.The main preop-erative diagnoses were appendiceal masses in7.1%(1 case)of the patients,ovarian masses in 7.1%(1 case),ovarian cysts,acute or chronic appendicitis,ovarian malignancies,and uterine fibroids in 21.4%(3 cases)respectively.As for the source of appendiceal speci-mens,28.6%(4 cases)had the appendix removed due to appendiceal inflammation or appendiceal masses,42.9%(6 cases)had the appendix removed due to abnormal morphology observed during surgery,21.4%(3 cases)had the appendix removed routinely during the resection of ovarian malignancies,and 7.1%(1 case)had the appendix removed due to close adhesion to the right ovary during right adnexectomy.Three cases involved the removal of ovarian cysts,and one case involved the removal of the right ovary;all pathologically confirmed the presence of ovarian endometriotic cysts.Four cases underwent concurrent hysterectomy with unilateral or bilateral adne-xectomy,among which three cases had both ovarian endometriotic cysts and adenomyosis,and one case had adenomyosis alone.The locations of appendiceal endometriosis were 50%(7 cases)in the muscular layer,21.4%(3 cases)in the outer membrane,7.1%(1 case)in the serosa,and21.4%(3 cases)in both the muscular layer and outer membrane.Case1 had concurrent appendiceal mucinous adenoma,and case 13 had concurrent appendiceal mucinous adenoma and appendiceal carcinoid.All patients underwent minimally inva-sive laparoscopic surgery to remove the appendix.Conclusions:For childbearing age women clinically diagnosed with endometriosis,especially those who experience recurrent lower right abdominal pain,gynecologists and surgeons need to carefully consider the possibility of appendiceal endometriosis.If appendiceal endometriosis is present,it is highly likely to cause acute or chronic inflammation in the appendix,which often requires surgical treatment,and gynecologists and surgeons should pay high attention.
万方数据
维普
