title: Tuba ovarian abscesses formation from decidualized ovarian endometrioma after appendiceal endometriosis presenting as acute appendicitis in pregnancy.
abstract: BACKGROUND
  Acute appendicitis with appendicial endometriosis is a very infrequently encountered condition during pregnancy. Decidualization is the hypertrophy of endometrial stromal cells by the effect of progesterone. Similarly, in pregnancy, ectopic stromal endometrial cells in endometriosis can also be transformed by the same mechanism and ectopic decidua (deciduosis) may occur.
  
  
  METHODS
  Here we report a 30 year old pregnant woman presenting twice with acute abdominal symptoms requiring surgery for appendicial and ovarian endometriosis and deciduosis. We emphasize that deciudualized endometriosis may first present during pregnancy with acute abdomen necessitating emergency laparotomy and complicating the course of gestation.
  
  
  CONCLUSIONS
  To our knowledge only 9 cases in which decidualized endometriotic tissue causing acute abdomen necessitating surgery during pregnancy were reported in the literature. What makes our case special is that the patient needed two laparotomies during the pregnancy period which was a very stressful situation for both the patient and the physicians.
authors.affiliation: Department of Obstetrics and Gynecology, Dokuz Eylul University, School of Medicine, Izmir, Turkey.
authors.forename: Erbil
authors.initials: E
authors.lastname: Dogan
authors.affiliation: Department of Obstetrics and Gynecology, Dokuz Eylul University, School of Medicine, Izmir, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Okyay
authors.affiliation: Department of Obstetrics and Gynecology, Dokuz Eylul University, School of Medicine, Izmir, Turkey.
authors.forename: Bahadir
authors.initials: B
authors.lastname: Saatli
authors.affiliation: Department of Obstetrics and Gynecology, Dokuz Eylul University, School of Medicine, Izmir, Turkey.
authors.forename: Safak
authors.initials: S
authors.lastname: Olgan
authors.affiliation: Department of Pathology, Dokuz Eylul University, School of Medicine, Izmir, Turkey.
authors.forename: Sulen
authors.initials: S
authors.lastname: Sarioglu
authors.affiliation: Department of Pathology, Dokuz Eylul University, School of Medicine, Izmir, Turkey.
authors.forename: Meral
authors.initials: M
authors.lastname: Koyuncuoglu
keywords: Acute appendicitis; Deciduosis; Endometriosis; Tuba ovarian abscess