Endometriosis and the Appendix
The appendix is considered one of the most common sites affected by endometriosis within the digestive system. Most symptoms appear as bloating, gas, and pain—especially in the lower right quadrant of the abdomen. Typically, if the disease is found in this way, the appendix is completely removed during a laparoscopic procedure.
We present to you one of the many cases seen at Al-Omam Hospital in Egypt, involving both endometriosis and the appendix.
The case concerns a 35-year-old single woman who had previously undergone traditional abdominal surgery. She was complaining of lower back pain, abdominal and pelvic pain especially on the right side, weight gain, white vaginal discharge, and constipation accompanied by abdominal cramps.
Her ovarian reserve was low due to previous abdominal surgeries and the removal of endometriomas through traditional surgical methods, which caused adhesions and further diminished ovarian reserve as a result of rough handling of the ovaries during surgery. This is why we always advocate for laparoscopic surgery instead of traditional open surgery, due to the latter’s negative impact on a woman’s body.
A decision was made to perform a laparoscopy, and the following was found:
- A 3.4 cm endometrioma on the ovary, which was removed along with its follicular cyst.
- Endometriosis in the peritoneal membrane and the Pouch of Douglas, which was excised.
- Severe adhesions caused by the previous traditional surgery, all of which were successfully removed.
- The appendix was inflamed, twisted around itself, and was difficult to diagnose without laparoscopy.
The appendix is considered a strong indicator of endometriosis, especially in adolescents, as it is located close to the common sites of the disease and is one of the first organs to become inflamed—often requiring surgical intervention. This allows for early detection of the disease. Therefore, we always recommend laparoscopy performed by a specialist.
Advice to every young woman:
If you experience irregular bowel movements—especially during your period—and have pain in the lower right side of the abdomen, don’t ignore it.