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Catamenial Appendicitis

From the Departments of ¹Obstetrics, Gynecology and Women’s Health; ²Anatomic Pathology; ³Biomedical Sciences, College of Veterinary Medicine; and ⁴Division of Minimally Invasive Surgery, Department of General Surgery, University of Missouri, Columbia, Missouri.

ABSTRACT

BACKGROUND: Reproductive-aged women undergoing appendectomy for suspected appendicitis have twice the rate of negative histology as age-matched men. The reason for this discrepancy is unknown.

CASES: Three patients with peritoneal endometriosis and recurrent symptoms of acute appendicitis coincident with menses underwent resection of a noninflamed appendix with long-term symptom resolution. Standard pathological evaluation failed to demonstrate evidence of appendiceal endometriosis or appendicitis. Additional evaluation demonstrated a marked increase in number of mast cells in the appendiceal muscularis compared with normal appendices.

CONCLUSION: The term "catamenial appendicitis" has been coined to describe these cases, and a mechanism of pathogenesis of right lower quadrant pain and nausea in patients with histologically confirmed endometriosis is proposed.

This article has been cited by other articles:

				B. F. Barrier Catamenial Appendicitis Obstet. Gynecol., June 1, 2008; 111(6): 1446 - 1446. [Full Text] [PDF]

				A. Basaran Catamenial Appendicitis Obstet. Gynecol., June 1, 2008; 111(6): 1445 - 1445. [Full Text] [PDF]