Introduction:

Endometriosis is a common disease, characterized by endometrial tissue outside the uterus. It represents 3% of cases with gastrointestinal affection and < 1% of all cases of endometriosis.

Case report:

A 27 years old female, admitted in emergency due to abdominal pain in the right lower quadrant with 12 hours evolution; associated to nausea and vomiting on one occasion and three diarrheal stools. On physical: cardiac frequency 90/min; TA 120/80 mmHg; RF 18 min; afebrile; abdomen with peristalsis present, severe pain in right lower quadrant, positives signs of McBurney, Rovsing, Von Blumberg and Psoas. Laboratory studies reported leukocytosis of 11,800 with 87% segmented; ultrasound study was suggestive of acute appendiceal process, appendix of 6.6 mm in its transverse diameter and presence of peri-appendicular nodes. Laparoscopic appendectomy was performed, pathology reported a local acute peri-appendicitis secondary to appendiceal endometriosis with multiple foci at the level of the muscle layer and subserosa.

Conclusions:

Endometriosis affects the cecal appendix in 3% of cases, so this diagnostic must be present in the differential diagnosis of cases with acute abdomen.