Department of General Internal Medicine, Takatsuki General Hospital, Japan.
Department of Pathology, Takatsuki General Hospital, Japan.
Intern Med. 2021 May 15;60(10):1641-1644. doi: 10.2169/internalmedicine.5960-20. Epub 2020 Dec 22.
Acute appendicitis is an important differential diagnosis in patients with right lower quadrant pain during pregnancy. Endometriosis, a hormone-related pathology, is another possibility. Patients with endometriosis are typically symptomatic before pregnancy. Stromal endometriosis is a variant of endometriosis that presents no symptoms before pregnancy but which occasionally presents with the new onset of symptoms during pregnancy. We report the case of a 35-year-old woman in her 8th month of pregnancy who presented with impending appendiceal rupture due to deciduosis of the appendix, a progesterone-related condition, during pregnancy. This case suggests that deciduosis/stromal endometriosis should be considered as a differential diagnosis of acute abdomen during pregnancy, even if the patient is asymptomatic before pregnancy.
急性阑尾炎是妊娠期右下腹痛的重要鉴别诊断。子宫内膜异位症是另一种与激素相关的病理情况。子宫内膜异位症患者通常在怀孕前就有症状。间质子宫内膜异位症是一种在怀孕前没有症状的子宫内膜异位症变体,但偶尔会在怀孕期间出现新的症状。我们报告了一例 35 岁的孕妇,她在怀孕 8 个月时因孕激素相关的阑尾蜕膜化而出现阑尾即将破裂,这是一种与孕激素相关的疾病。这个病例表明,即使患者在怀孕前没有症状,蜕膜化/间质子宫内膜异位症也应该被认为是妊娠期急腹症的鉴别诊断之一。