Acute appendicitis is the most common surgical emergency, and is also the most common cause of non-gynecological pelvic pain. Female patients presenting with abdominal pain in the presence of an underlying gynecological pathology such as ectopic pregnancy, threatened abortion, ovarian cyst, tubo-ovarian abscess or pelvic inflammatory disease can mimic acute appendicitis, potentially complicate the clinical picture and affect the diagnostic accuracy. Open or laparoscopic surgery is the mainstay of management for Complicated Appendicitis. Our patient was operated having signs and symptoms of pelvic peritonitis, with intraoperative finding of pelvic cavity blood with right ruptured ovarian simple cyst. She also had significant appendiceal abscess contained by omentum, terminal ilium, cecum and sigmoid colon with eaten up appendix in the abscess. This is a rare co-occurrence of appendiceal abscess with ruptured ovarian cyst, only one previous published case report of acute appendicitis with ruptured ovarian cyst.
Keywords: complicated appendicitis, ovarian cyst rupture.