Chou Ching-Wen, Lai Po-Ta, Huang Chu-Chun, Hong Jin-Bon, Tai Yi-Jou
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Taiwan J Obstet Gynecol. 2023 May;62(3):474-479. doi: 10.1016/j.tjog.2023.02.003.
While endometriosis is common, inguinal endometriosis with hernia is rarely observed, making its preoperative diagnosis challenging.
We report two cases of inguinal endometriosis with different presentations and focus on tailored surgical treatment. The two patients in our series presented with painful swelling in the right groin area. Surgery and pathological examination confirmed the diagnosis of endometriosis in both cases. Herniorrhaphy and excision of the extraperitoneal round ligament were performed in one patient with concomitant inguinal endometriosis and indirect inguinal hernia.
We highlight the importance of the preoperative evaluation of concomitant pelvic endometriosis, round ligament involvement, and endometriosis within the inguinal hernia sac. Inguinal endometriosis with or without hernia should be considered even in reproductive-aged women without a previous medical and surgical history. Postoperative hormonal therapy, including dienogest, can be considered to prevent disease recurrence.
虽然子宫内膜异位症很常见，但腹股沟子宫内膜异位症合并疝却很少见，这使得其术前诊断具有挑战性。
我们报告了两例表现不同的腹股沟子宫内膜异位症病例，并重点介绍了针对性的手术治疗。我们系列中的两名患者均表现为右侧腹股沟区疼痛性肿胀。手术及病理检查证实两例均为子宫内膜异位症。对一名合并腹股沟子宫内膜异位症和间接性腹股沟疝的患者进行了疝修补术及腹膜外圆韧带切除术。
我们强调术前评估合并盆腔子宫内膜异位症、圆韧带受累情况以及腹股沟疝囊内子宫内膜异位症的重要性。即使是既往无病史和手术史的育龄女性，也应考虑有无腹股沟子宫内膜异位症合并疝的情况。术后可考虑使用包括地诺孕素在内的激素疗法预防疾病复发。
