Ao Xue, Xiong Wei, Tan Shi-Qiao
Department of Obstetrics and Gynecology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, Sichuan Province, China.
World J Clin Cases. 2020 Apr 26;8(8):1532-1537. doi: 10.12998/wjcc.v8.i8.1532.
Abdominal wall endometriosis can occur secondary to gynecological and obstetric pelvic laparotomy; however, this is a rare clinical event. There are few cases of endometriosis involving the incision site of a laparoscopic surgery, especially for those of the endometrial nodule at the umbilical trocar port site where the camera is placed.
We describe the case of a 37-year-old woman who presented with a 2-year history of a tough swelling below the umbilicus, which presented periodical pain during menstruation. The patient had undergone laparoscopic ovarian cystectomy 4 years prior, and we theorized that the umbilical nodule was a complication of that laparoscopic surgery. Histological analysis confirmed the diagnosis of abdominal umbilical scar endometriosis secondary to previous laparoscopic surgery. Surgical removal of the nodule followed by three cycles of leuprorelin was curative.
Abdominal mass and pain in women of childbearing age with a previous history of pelvic surgery should support consideration of endometriosis at the surgical site.
腹壁子宫内膜异位症可继发于妇产科盆腔剖腹手术；然而，这是一种罕见的临床情况。腹腔镜手术切口部位发生子宫内膜异位症的病例很少，尤其是在放置摄像头的脐部套管针端口部位出现子宫内膜结节的情况。
我们描述了一名37岁女性的病例，她脐下出现质地硬的肿块已有2年病史，月经期间出现周期性疼痛。该患者4年前接受了腹腔镜卵巢囊肿切除术，我们推测脐部结节是那次腹腔镜手术的并发症。组织学分析证实诊断为既往腹腔镜手术后继发的腹部脐部瘢痕子宫内膜异位症。手术切除结节并随后进行三个周期的亮丙瑞林治疗后治愈。
有盆腔手术史的育龄女性出现腹部肿块和疼痛时，应考虑手术部位存在子宫内膜异位症。
