Appendiceal endometriosis invading the sigmoid colon: a rare entity

PurposeWe report an unusual case of endometriosis of the appendix with simultaneous invasion of the sigmoid colon.MethodsClinical, radiological, surgical, and histological data of the patient were reviewed, as well as the current literature on gastrointestinal endometriosis.ResultsA 41-year-old woman presented to the emergency department of our hospital with acute right lower quadrant pain, pronounced tenderness elevated white blood cell count, and increasedC-reactive protein. Abdominal CT scan suggested a mucocele of the appendix. The patient was first treated with antibiotics, followed by en bloc resection of the appendix and of the sigmoid colon 2months later. Histological examination revealed an endometriotic nodule of the appendix filling the appendiceal lumen and resulting in a mucocele which invaded the sigmoid colon wall.ConclusionsThe diagnosis of gastrointestinal endometriosis can be challenging due to the variety of symptoms it can produce. Although extremely rare, a concomitant double gastrointestinal location of endometriosis may be possible and should be considered in women of reproductive age.