Mehmet ESER, Semra KAYATAŞ, Aylin ACAR, Kayhan BAŞAK, LEVENT KAPTANOĞLU

Akut Apandisiti Taklit Eden Apandiks Endometriozisleri: 2 Olgu

Giriş: Gastrointestinal sistemde endometriozis gelişimi sık görülmemekle birlikte apandiks endometriozisi oldukça nadirdir.Gebelikte endometriosiz çok daha nadirdir. Bu çalışmada, akut apandisit ön tanısı ile opere edilen ve patolojik inceleme sonucunda apandiks endometriozisi saptanan, birisi gebe olan iki olgu sunulmaktadır. Olgu 1: Otuz-iki yaşında 34 haftalık gebe olgu, üç gündür devam eden sağ alt kadran ağrısı ve bulantı şikayetleri ile başvurdu. Fizik muayene ve laboratuar bulguları akut apandisit ile uyumlu idi. Operasyon planlandı. Apandiks duvar görünümü ve peritoneal kavitede bulunan minimal serohemorajik sıvı erken perforasyon olarak tanımlandı. Apandektomi yapıldı. Histopatolojik incelemede; perforasyon izlenmediği ve apandiksde endometriosiz odakları olduğu rapor edildi. Olgu 2: Otuz yaşında kadın hasta, bir gün önce başlayan sağ alt kadran ağrısı, bulantı ve kusma şikayetleri ile başvurdu. Fizik muayenede McBurney noktasında hassasiyet, defans ve rebound izlendi. Akut apandisit tanısı ile operasyon planlandı. Operasyonda, apendiks hiperemikti, peritoneal kavitede sıvı görülmedi, apandektomi yapıldı. Histopatolojik incelemede akut apandisit lehine mikroskopik bulgu saptanmadı, apandiks endometriozisi olarak raporlandı.

Introduction: Involvement of endometriosis in the gastrointestinal tract is uncommon and endometriosis of the appendix is an even rarer occurrence. The occurence of appendicial endometriozis in pregnant women is also rare case. We aimed to report two cases of woman who was pregnant, with appendiceal endometriosis that presented as acute appendicitis. Case 1: A 32-year-old woman with 34 weeks of pregnancy was admitted with a 3-day history of right iliac fossa pain and nausea. Physical examination and laboratory findings increased the suspicion of acute appendicitis. Operation was planed. Appearance of appendix and the presence of serohemoragic fluid in peritoneal cavity lead us to think an early perforated appendix and apendectomy was done. Histopatological evaluation revealed ectopic endometrial glands with stroma in the serosa of the appendix without appearance of perforation.. Case 2: A 30-year-old woman was admitted with a chief complaint of right iliac fossa pain, nausea and vomiting. Physical examination revealed pain which was localised to the McBurneys point, with tenderness, guarding and rigidity. Operation was planed. At surgery, there was a fluid in peritoneal cavity and the appendix appeared hyperemic. An appendectomy was performed. The histological diagnosis was appendiceal endometriosis with no microscopical evidence of acute appendicitis.

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