Endometriosis of the appendix presenting as acute appendicitis

Acute appendicitis is a surgical emergency and accounts for 27.5% of the surgical cases. It is a very common cause of non-gynecologic lower abdominal pain and may occur simultaneously with a variety of gynecologic diseases. We report a case of a 24 years old female, who presented to the surgical emergency department with complaints of acute pain in abdomen for the last 1 day with tenderness in right iliac fossa. Laboratory reports showed leucocytosis with neutrophilia, with presence of toxic granules. A provisional diagnosis of appendicitis was made and the patient was operated. The appendectomy specimen on histopathological examination showed ectopic endometrial glands and stroma in the serosa, based on which a diagnosis of appendiceal endometriosis was given. This case emphasizes the importance of considering the diagnosis of appendiceal endometriosis in a young female of child bearing age with a clinical diagnosis of appendicitis.