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Consider chronic appendicitis as potential cause of pelvic pain. (Case Report).
SAN FRANCISCO -- A rare case report suggests that chronic appendicitis should be included in the differential diagnosis when evaluating chronic pelvic pain, Dr. Armando E. Hernandez said in a poster presentation at the annual meeting of the American Association of Gynecologic Laparoscopists.
He described a 33-year-old woman who had never been pregnant who complained of dyspareunia, minimal dysmenorrhea, and 3 years of inability to conceive. She had an 8-month history of right lower quadrant pain. Two episodes of acute pain in the right lower quadrant led to a nondiagnostic evaluation for acute appendicitis.
Intraoperative evaluation of the chronic pelvic pain found an Allen-Masters peritoneal defect, right hydrosalpinx with obstruction of the left fallopian tube on chromopertubation, and an abnormal-appearing appendix, which was excised.
Histologic evaluation showed submucosal fat deposition in the distal portion of the appendix with an associated chronic inflammatory reaction, findings concordant with chronic appendicitis. There was no histologic evidence of endometriosis.
Five months later the patient remained asymptomatic and was 12 weeks pregnant, said Dr. Hernandez of the University of Miami.
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Source: HighBeam Research, Consider chronic appendicitis as potential cause of pelvic pain....