Deciduose der Appendix

Hauptmann, J.; Mechtersheimer, Gunhild; Bläker, Hendrik; Schaupp, Willis C.; Otto, H

doi:10.1007/s001040051019

Cited by 15 publications

(15 citation statements)

References 9 publications

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“…The lesion infiltrates the serosal surface of all abdominal viscera, as occurs in carcinomatosis from metastatic adenocarcinomas, squamous cell carcinomas, and malignant deciduoid mesothelioma. 16,23,25 Decidualized endometrial stromal cells observed on a Papanicoloau smear may confound diagnosis of a cervical intraepithelial neoplasia. 9 Rarely, decidualized aberrant stroma or endometriosis tissue may also directly complicate pregnancy through hemoperitoneum, intestinal perforation, or pneumothorax.…”

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confidence: 99%

Decidualization of Endometriosis in Macaques

et al. 2016

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The decidua is the superficial portion of endometrium that transforms, or decidualizes, under the influence of progesterone to nourish the early embryo during pregnancy. Deciduae outside of the uterus are found in nearly 100% of human pregnancies. This condition known as deciduosis may mimic malignancy, resulting in additional diagnostic procedures that place the mother or baby or both at risk. Deciduosis has been described in both Old and New World nonhuman primates in conjunction with pregnancy and after treatment with exogenous progestins. Here the authors present 6 cases of deciduosis associated with endometriotic lesions in female rhesus and cynomolgus macaques (Macaca mulatta and Macaca fascicularis). Full diagnostic necropsies with histological analyses were performed on all animals. Deciduae were stained with hematoxylin & eosin and by immunohistochemistry for vimentin, CD10, progesterone receptor, estrogen receptor, desmin, cytokeratin, kermix P8, chorionic gonadotropin, human placental lactogen, and calretinin. The most common clinical signs were abdominal pain (4 of 6) and anorexia (2 of 6). At necropsy, macaque uteri were often enlarged or disfigured (4 of 6) with abundant fibrous adhesions (5 of 6). Affected tissue consisted of epithelial-lined cysts and decidualized stroma with scattered gamma/delta T cells. Decidualized stromal cells were large and polyhedral with abundant cytoplasm and round, vesicular nuclei. They stained positive for vimentin, CD10, progesterone and estrogen. In summary, these cases illustrate deciduosis in 6 nonhuman primates with endometriosis. Understanding decidualization in nonhuman primates will aid in elucidating the pathophysiology of deciduosis during pregnancy or endometriosis and potentially lead to new interventions.

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confidence: 99%

Decidualization of Endometriosis in Macaques

et al. 2016

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“…Differential diagnosis of acute appendicitis may provide various conditions: (I) medical emergencies (porphyria, dia- betic ketoacidosis, glomerulonephritis, pyelonephritis); (II) gynecological emergencies (overian cyst rupture, tubaovarian abscess, fallopian tube torsion); (III) non-gynecological emergencies (mesenteric lymphadenitis, acute cholecystitis, acute pancreatitis, peptic ulcus perforation, intestinal obstruction); and (IV) obstetrical emergencies (preterm labor, ectopic pregnancy, preeclampsia) [3,25]. In our study, urological, gynecological, and intestinal conditions were investigated in the differential diagnosis, and appropriate treatments were performed accordingly.…”

Section: Discussionmentioning

confidence: 99%

Acute Appendicits in Pregnancy: Evaluation of 129 Patients During 20 years

Onder

2012

J Curr Surg

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Background: Acute appendicitis is the most common non-obstetric emergency requiring surgery during pregnancy, and delayed diagnosis is associated with a greater risk of fetal or maternal morbidity and fetal loss. The aim of this study is to analyze the diagnosis of acute appendicitis during pregnancy, along with maternal and fetal complications. Methods:Between January 1990 and December 2010, 129 pregnant women who were operated on due to acute appendicitis were evaluated retrospectively. Results:The mean age of patients was 28.3 ± 6.6 years, and the time from presentation of symptoms to admission was 41.1 ± 33.2 hours. The most common complaints were lower right quadrant pain (66.7%) and nausea-vomiting (65.1%). The most common physical signs were abdominal tenderness and rebound. Gestational stage at diagnosis was second trimester in 74 patients, first trimester in 31 patients, and third trimester in 24 patients. The perforation rate among our cases was 28.7%. The perforation-associated with delayed admission to the hospital (P = 0.001) was the most common in the first trimester with a rate of 40.5%. Morbidity occurred in 41 patients (31.8%). Fetal mortality occurred in 1 (1.1%) of nonperforated patients, and in 5 of the perforated patients (13.5%). No maternal mortality occurred. Mean hospital stay was 2.8 ± 0.9 days in non-perforated patients, while 5.3 ± 2.2 days in perforated patients (P = 0.001). Conclusions:Because of the nonspecific and pregnancy-attributed symptoms, acute appendicitis during pregnancy may result in an increased risk of fetomaternal morbidity and fetal mortality.

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“…Ectopic deciduosis is a known phenomenon, described in different locations as cervix uteri [8], ovary [9], fallopian tubes, appendix [10], peritoneum [6], omentum [4], diaphragm, liver, spleen, pleura [11], lymph nodes [12], renal pelvis [13], skin [14]. Clinically extra uterine ectopic deciduosis may easily simulate disseminated tuberculosis [3] or metastatic disease [2].…”

Section: Discussionmentioning

confidence: 99%

Ectopic Decidua Presenting With a Sigmoid Bowel Perforation: A Case Report

Gradauskas¹,

Činčikas²,

Daunoravicius³

et al. 2012

J Clin Case Rep

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The occurrence of ectopic decidua has been observed mostly in the ovaries, uterus and cervix. Ectopic gastrointestinal deciduosis is a physiological condition. Only several cases of ectopic decidua, causing complications have been presented in literature. To the best of our knowledge, sigmoid or any other bowel perforation, caused by deciduosis, has not been previously reported in literature.Case presentation: A 40-year old patient primigravida (32 weeks of gestation) was admitted with a severe abdominal pain and obstipation. An abdominal sonography was performed but no visual cause of the pain was diagnosed. Two days after admission the episode of severe pain reappeared. An abdominal sonography and x-ray showed "free air" under both domes of diaphragm. A laparotomy was performed. No perforation of hollow viscus was found. On the fifth postoperative day, the patient started to complain about acute abdominal pain. The decision was made to perform relaparotomy (a Caesarean section and reexploration of abdominal cavity during the same operation). During the relaparotomy a part of sigmoid colon was visually altered. A microperforation on tumour-like structures was found in the sigmoid colon. A Sigmoid resection was performed. Currently the patient has no residual complaints and is enjoying her motherhood. Conclusion:We assert that ectopic decidua can result in a perforation of the hollow viscus, which is a lifethreatening condition and should always be taken into account seriously. We believe that sigmoid microperforation could have found, we had taken a more aggressive approach and performed a Caesarean section during the first operation.

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Deciduose der Appendix

Cited by 15 publications

References 9 publications

Decidualization of Endometriosis in Macaques

Decidualization of Endometriosis in Macaques

Acute Appendicits in Pregnancy: Evaluation of 129 Patients During 20 years

Ectopic Decidua Presenting With a Sigmoid Bowel Perforation: A Case Report

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