Endometriosis and appendicitis

Abstract

Introduction: Endometriosis is a common condition that can affect up to 15% of women of childbearing age. Women with endometriosis have multiple surgeries due to algic syndrome, infertility, endometriomas, and adherence, one of the pathologies is also appendicitis. The risks and benefits associated with an elective coincidental appendectomy should be considered. Aim of the study: Assessing the incidence of appendicitis in patients with different forms of endometriosis compared to patients without endometriosis. Material and methods: In a retrospective study, data were obtained by chart review of an internal database for women who had endometriosis. We analyzed 318 women with endometriosis and infertility and 150 women with infertility who underwent diagnostic laparoscopy for 3 years (2014-2016). We compared the rate of endometriosis of the appendix in women who were diagnosed with deep infiltrating endometriosis (DIE), superficial endometriosis, or no endometriosis. Results: Endometriosis was diagnosed for 318 women, 165 (51,88%) had deep endometriosis and 153 (48,11%) superficial endometriosis. The prevalence of AppE was 23,27% (74/318) overall; 18 (11,76%) of 153 women with superficial endometriosis and 56 (33,93%) of 165 with DE were affected. The prevalence of Appendicitis in the control group is 4,6 % (7/150). The frequency of AppE was increased among women with DE, abnormal appendix appearance, and surgical indication (all P<0.001). Women with DE had a higher risk of AppE compared with women without endometriosis, controlling for appendiceal appearance and surgical indication, and a higher risk of AppE compared with those with superficial endometriosis. Conclusion: The study demonstrated the need to check the appendix in patients with endometriosis, particularly those with deep ovarian endometriosis on the right (endometrium on the right), and its removal during endometriosis surgery, which would reduce the need for repeated surgery 5 times compared to patients without endometriosis. Women with DE have an increased risk of AppE. Coincidental appendectomy should form part of complete endometriosis excision for these patients.