Proposito Delia, Negro Paolo, Gossetti Francesco, Di Paola Massimiliano, Montemurro Leonardo, Gallina Stefano, Veltri Salvatore, Corazza Valerio, Brugiotti Carlo, Antonellis Fabio, Uccini Stefania, Carboni Manlio
Divisione di Chirurgia Generale, Dipartimento di Chirurgia Generale, Specialità Chirurgiche e Trapianti d'Organo Paride Stefanini, Azienda Policlinico Umberto 1, Università La Sapienza di Roma.
Chir Ital. 2002 Sep-Oct;54(5):699-708.
Extragonadal endometriosis is rarely diagnosed preoperatively for the variety of its localizations. Presentations to general surgeons may be atypical and pose diagnostic difficulty, mimicking other acute diseases. We report three cases treated with surgical operation. Case 1: a 28-year-old woman admitted for bowel obstruction due to coecal endometriosis, with appendix mucocele, peritoneal pseudomyxoma and ovarian endometrioma. The patient underwent right colectomy and right adnexectomy in the emergency setting. Case 2: a 31-year-old woman with endometriosis of the distal extraperitoneal portion of the round ligament presenting as an irreducible inguinal hernia. An operation was performed: the round ligament and a polycystic structure encompassing it were completely excised. Case 3: a 41-year-old woman, with umbilical endometriosis diagnosed by her gynaecologist, was admitted to our department for excision. Surgical treatment of extragonadal endometriosis is adequate. However, postoperative follow-up is mandatory and hormonal suppressive therapy may be indicated by the gynaecologist.
由于性腺外子宫内膜异位症的位置多样，术前很少能做出诊断。其表现可能不典型，给普通外科医生带来诊断困难，易与其他急性疾病相混淆。我们报告三例接受手术治疗的病例。病例1：一名28岁女性因盲肠子宫内膜异位症导致肠梗阻入院，伴有阑尾黏液囊肿、腹膜假黏液瘤和卵巢子宫内膜瘤。患者在急诊情况下接受了右半结肠切除术和右侧附件切除术。病例2：一名31岁女性，圆韧带腹膜外远端子宫内膜异位症表现为不可复性腹股沟疝。进行了手术：完全切除了圆韧带及其周围的多囊结构。病例3：一名41岁女性，经妇科医生诊断为脐部子宫内膜异位症，因切除术入住我科。性腺外子宫内膜异位症的手术治疗是恰当的。然而，术后随访是必需的，妇科医生可能会建议进行激素抑制治疗。
