Dessy Luca A, Buccheri Ernesto M, Chiummariello Stefano, Gagliardi Davide N, Onesti Maria G
Department of Plastic and Reconstructive Surgery, University La Sapienza, Rome, Italy.
In Vivo. 2008 Nov-Dec;22(6):811-5.
Endometriosis is the presence of functioning endometrial tissue outside the uterine cavity. Umbilical endometriosis has been reported in more than one hundred cases and the umbilicus represents the location of 0.5-1% of ectopical endometrioses. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis.
We report our experience in preoperative differential diagnosis and treatment of four cases of umbilical endometriosis. An accurate anamnesis and clinical examination together with the use of 13 MHz probe ultrasonography with echocolor duplex scan led us to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result.
In all treated cases, a hemi-circumferential incision in the inner aspect of the umbilical opening was performed allowing adequate access to the lesion and umbilical repositioning. At the follow-up visit (from 6 to 24 months after surgery), no symptoms or signs of recurrence were evidenced. A natural-looking umbilicus was observed in all cases with minimal visible scars.
子宫内膜异位症是指子宫腔外存在有功能的子宫内膜组织。脐部子宫内膜异位症已有一百多例报道，脐部是异位子宫内膜异位症的0.5%-1%的发病部位。正确的鉴别诊断可能困难，建议使用荧光检查和磁共振成像以提高术前诊断的准确性。
我们报告了4例脐部子宫内膜异位症术前鉴别诊断和治疗的经验。准确的病史采集和临床检查，以及使用13兆赫探头超声检查和彩色双功超声扫描，使我们能够准确地对脐部子宫内膜异位症进行术前诊断。脐部子宫内膜异位症的手术方法是取得满意结果的重要一步。
在所有治疗病例中，均在脐孔内侧做半环形切口，以便充分暴露病变并重新定位脐部。在随访（术后6至24个月）中，未发现复发的症状或体征。所有病例均观察到外观自然的脐部，可见疤痕极小。
