Choi Joseph Do Woong, Yunaev Michael
Department of Surgery, Norwest Private Hospital, Sydney, New South Wales, Australia.
BMJ Case Rep. 2019 Jul 22;12(7):e230496. doi: 10.1136/bcr-2019-230496.
A 29-year-old, otherwise well, nulligravid woman presented to the emergency department with 1-day history of generalised abdominal pain and vomiting. She had similar symptoms 6 months prior following recent menstruations, which resolved conservatively. She had no prior history of abdominal surgery or endometriosis. CT scan demonstrated distal small bowel obstruction. A congenital band adhesion was suspected, and she underwent prompt surgical intervention. During laparoscopy, a thickened appendix was adhered to a segment of distal ileum. There was blood in the pelvis. Laparoscopic adhesiolysis and appendicectomy were performed. Histopathology demonstrated multiple foci of endometriosis of the appendix with endometrial glands surrounded by endometrial stroma. Oestrogen receptor and CD10 immunostains highlighted the endometriotic foci. The patient made a good recovery and was referred to a gynaecologist for further management.
一名29岁、平素健康的未孕女性因1天的全腹疼痛和呕吐症状就诊于急诊科。6个月前她在近期月经后也曾出现类似症状，经保守治疗后缓解。她既往无腹部手术史或子宫内膜异位症病史。CT扫描显示远端小肠梗阻。怀疑为先天性束带粘连，遂对其进行了及时的手术干预。腹腔镜检查时，发现增厚的阑尾与一段远端回肠粘连。盆腔内有血液。进行了腹腔镜粘连松解术和阑尾切除术。组织病理学显示阑尾存在多处子宫内膜异位灶，有被子宫内膜间质包绕的子宫内膜腺体。雌激素受体和CD10免疫染色突出了子宫内膜异位灶。患者恢复良好，并被转诊至妇科医生处进行进一步治疗。
