A clinical case of hybrid surgical treatment of extragenital endometriosis of the appendix with the use of laparoscopic and endoscopic techniques

Introduction. Extragenital endometriosis is a rare pathology with nonspecific and variable symptoms and the possibility of establishing a final diagnosis only based on the results of IHC studies. Treatment is either surgical or conservative, and the criteria for choosing tactics have not yet been fully determined.Clinical case. During the clinical examination, the patient revealed the formation of the right ovary and the formation of the right iliac region, assessed by ultrasound, CT of the abdominal cavity with intravenous and oral contrast, colonoscopy as an invaginate of the phlegmonous altered appendix. A hybrid operation was performed: laparoscopic resection of the dome of the rectum under endoscopic control, cystectomy on the right, enucleation of the capsule of the endometrioid cyst of the left ovary. The results of the IHC study revealed endometriosis of the intestinal wall. In the postoperative period anti-relapse therapy was prescribed.Conclusions. This clinical case demonstrates the problems of diagnosing extragenital endometriosis, as well as the advantage of surgical treatment, in particular, hybrid laparoscopic-endoscopic, in case of hard-to-reach localization of the formation for final morphological verification.