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Erschienen in:
15.05.2018 | GI Image
Complete Appendiceal Intussusception Associated with Endometriosis
Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 1/2019
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A 50-year-old asymptomatic woman presented for a screening colonoscopy and was found to have an enlarged inverted appendix (Fig. 1a). Further investigation by magnetic resonance imaging (MRI) revealed a hypervascular solid lesion at the base of the cecum with nonvisualization of the appendix. Her past medical history is significant for Hashimoto thyroiditis, and endometriosis which led to a hysterectomy and left salpingo-oophorectomy. Pre-operative assessment favored a benign appendiceal intussusception and an ileocecectomy was performed. A complete intussuscepted appendix was identified grossly (Fig. 1b). Histology by hematoxylin and eosin (H&E) showed intussusception (Fig. 1c) associated with multicentric foci of endometriosis (Fig. 1d) primarily located in the muscularis propria, but focally extends to the periappendiceal tissues.
Fig. 1
Completely intussuscepted appendix with endometriosis. a Endoscopic view of an intussuscepted appendix at the appendiceal orifice. b Gross photograph of the intussuscepted appendix after ileocecectomy. c Cross section of the intussuscepted appendix with normal colonic type mucosa covering the outer surface (H&E, original magnification, × 20). d Foci of endometriosis in the muscularis propria of the intussuscepted appendix (original magnification, × 40)
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