# Appendicitis with Appendicular Phlegmon Secondary to Endometriosis

## TL;DR

This case report describes a rare instance of appendicitis caused by endometriosis in a 34-year-old woman, highlighting the importance of considering endometriosis in similar cases.

## Contribution

The novelty lies in documenting a rare case of appendiceal endometriosis presenting as complicated appendicitis, emphasizing diagnostic challenges and management.

## Key findings

- Appendiceal endometriosis was confirmed via histopathology after initial imaging suggested complicated appendicitis.
- The case highlights the need for a high index of suspicion in women of childbearing age to prevent complications.
- Prompt surgical intervention is recommended for definitive diagnosis and treatment.

## Abstract

Acute appendicitis is a common surgical emergency, however endometriosis in an appendix is a rare phenomenon. In this case report, we describe a 34-year-old woman who visited a teaching hospital on 2024, presenting with typical clinical features of appendicitis. Initial imaging revealed complicated appendicitis with perforation and an appendicolith; following conservative management, the patient was scheduled for an interval appendectomy which revealed an appendicular mass. A repeat surgery was scheduled, where extensive adhesions were noted, resulting in an open appendectomy. Histopathological examination confirmed appendiceal Endometriosis and a follow-up by a gynaecologist was arranged. Appendiceal Endometriosis is a rare phenomenon with variable clinical presentations, a high index of suspicion is necessary for women of childbearing age due to the risk of complications. The diagnosis of appendiceal Endometriosis is only confirmed via histopathology, and obtaining a Magnetic Resonance Imaging might aid in diagnosis; however, prompt surgical intervention is the standard of care.