A case report of endometriosis of the appendix with appendicoduodenal fistula

5 Citations
  • NISHIDA Y
    Department of Surgery, Kobe Rosai Hospital of the Labor Welfare Corporation
  • Urakawa Tomoaki
    Department of Surgery, Kobe Rosai Hospital of the Labor Welfare Corporation
  • Nakamoto Mitsuharu
    Department of Surgery, Kobe Rosai Hospital of the Labor Welfare Corporation
  • Kawaguchi Katsunori
    Department of Surgery, Kobe Rosai Hospital of the Labor Welfare Corporation
  • Sako Tatsuo
    Department of Surgery, Kobe Rosai Hospital of the Labor Welfare Corporation
  • Kamigaki Takashi
    Department of Surgery, Kobe Rosai Hospital of the Labor Welfare Corporation
  • Haranomura Hiroshi
    Department of Surgery, Kobe Rosai Hospital of the Labor Welfare Corporation
  • Nakae Shirou
    Department of Surgery, Kobe Rosai Hospital of the Labor Welfare Corporation
  • Nishio Sachio
    Department of Surgery, Kobe Rosai Hospital of the Labor Welfare Corporation
  • Ioroi Akio
    Department of Surgery, Kobe Rosai Hospital of the Labor Welfare Corporation
  • Uematsu Kiyoshi
    Department of Surgery, Kobe Rosai Hospital of the Labor Welfare Corporation
  • Iwakoshi Kazuhiko
    Department of Surgery, Kobe Rosai Hospital of the Labor Welfare Corporation
  • Imai Yukihiro
    First Department of Pathology, Kobe University School of Medicine

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Other Title
  • 十二指腸との内瘻を伴った虫垂子宮内膜症の1例

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Abstract

Endometriosis of the appendix has rarely been reported in Japan, as has spontaneous appendicoduodenal fistula. This is a case report of endometriosis of the appendix accompanied by a fistula of the duodenum. The patient, aged 68 years, was admitted to our department mainly for cancer of the ascending colon. From photographic examination we preoperatively diamosed appendicoduodenal fistula, right ovarian cyst, and ascending colon cancer, and performed an operation. The appendix, rising along the mesenteric side of the ascending colon, flexed and fibrously adhered to the right lower part of the third portion of the duodenum, making a fistula. We detached the adhesion and closed the fistula by direct suturing. Pathohistologicaly we found a glandular structure in the subserosal layer of the appendix and the cilia at the inner side of it, but no interstitial component or bleeding focus. Our case was asymptomatic and endometriosis of the appendix, which was accompanied by right ovarian endometriosis, was accidentally detected by postoperative pathological study. Endometriosis of the appendix is likely to be accompanied by that of intrapelvic organs, so we must pay attention to endometriosis of other organs before and during surgery, and perform an adequate operation.

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