Ultrasonography (US) of the abdomen (Philips iU22 System, Philips, Bothell, WA, USA) showed dilated and hyperperistalsis
small bowel with accumulation of large quantities of fluid.
When the appendix is involved in endometriosis (proliferation of endometrial glands outside the uterine cavity), the endometriosis deposits can lead to hyperperistalsis
and intussusception of the appendix, wholly or partially (1).
Predisposing factors are anatomical variations in the omentum and displacement of omentum caused by trauma, heavy exertion, hyperperistalsis
, obesity, overeating, sudden change in body position, coughing, sneezing, excessive strain, laxatives and use of occupational vibrating tools.
A range of aetiologies for the EIMD syndrome has been described such as production of oestrogen at the level of endometrium and ectopic endometrial lesions, chronic uterine peristaltic activity or phases of hyperperistalsis
, increased invasiveness of the basal endometrium, progesterone resistance, and defective trophoblast invasion.
and dysperistalsis as dysfunctions of the mechanism of rapid sperm transport in patients with endometriosis and infertility.
Summary of the various toxic syndromes Syndrome Examples Clinical clues Alpha adrenergic Phenylpropanolamine, Hypertension with phenylephrine reflex bradycardia; mydriasis Beta adrenergic Salbutamol, Hypotension, theophylline, caffeine tachycardia Mixed adrenergic Amphetamines, cocaine Hypertension with sympathomimetic) tachycardia; mydriasis; sweaty skin 3ympatholytic Methyldopa, opioids, Hypotension and phenothiazines bradycardia; miosis; decreased peristalsis Nicotinic Nicotine, Unpredictable; cholinergic succinylcholine fasciculations, paralysis 'Muscarinic None Bradycardia, miosis, cholinergic' sweating, hyperperistalsis
, bronchorrhoea, wheezing, excessive salivation, etc.