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Int J Gynaecol Obstet. 2017 Nov;139(2):149-154. doi: 10.1002/ijgo.12286. Epub 2017 Aug 18.

Risk of appendiceal endometriosis among women with deep-infiltrating endometriosis.

Author information

1
Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.
2
University of Tennessee Medical Center, Knoxville, TN, USA.
3
Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
4
Yale School of Nursing, New Haven, CT, USA.
5
Department of Obstetrics and Gynecology, WakeMed Physician Practices, Raleigh, NC, USA.
6
Department of Obstetrics and Gynecology, New York-Presbyterian/Lower Manhattan Hospital, New York, NY, USA.
7
Division of Family Planning, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.

Abstract

OBJECTIVE:

To determine whether deep-infiltrating endometriosis (DE) carries an increased risk of appendiceal endometriosis (AppE) as compared with superficial endometriosis or no endometriosis.

METHODS:

In a retrospective study, data were obtained by chart review of an internal database for women who underwent coincidental appendectomy during benign gynecologic surgery between July 2009 and February 2014 at a tertiary referral center in the USA. Univariate, bivariate, and regression analyses were performed. The primary exposure was surgically documented endometriosis (DE, superficial, or no endometriosis). The primary outcome was AppE.

RESULTS:

Endometriosis was diagnosed for 151 (38.2%) of 395 women; 82 (54.3%) had DE. The prevalence of AppE was 13.2% (52/395) overall; 8 (11.6%) of 69 women with superficial endometriosis and 32 (39.0%) of 82 with DE were affected. Frequency of AppE was increased among women with DE, abnormal appendix appearance, and surgical indication (all P<0.001). Women with DE had a 5.9-fold (95% confidence interval [CI] 2.9-11.9) higher risk of AppE compared with women without endometriosis, controlling for appendiceal appearance and surgical indication, and a 2.7-fold (95% CI 1.2-6.2) higher risk of AppE compared with those with superficial endometriosis.

CONCLUSION:

Women with DE have increased risk of AppE. Coincidental appendectomy should form part of complete endometriosis excision for these patients.

KEYWORDS:

Appendiceal endometriosis; Appendix; Deep-infiltrating endometriosis; Endometriosis

PMID:
28755505
DOI:
10.1002/ijgo.12286
[Indexed for MEDLINE]
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