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盆腔外子宫内膜异位症病例报告:外科医生视角及文献综述

A Case Report of Extrapelvic Endometriosis: Surgeon's Perspective and Review of the Literature.

作者信息

Sivagnanam Prabu Shankar, Bakry Husham, Aljawder Aysha

机构信息

General Surgery, King Hamad University Hospital, Bahrain Defence Force Royal Medical Services, Al Sayh, BHR.

Pathology, King Hamad University Hospital, Bahrain Defence Force Royal Medical Services, Al Sayh, BHR.

出版信息

Cureus. 2025 Jul 19;17(7):e88319. doi: 10.7759/cureus.88319. eCollection 2025 Jul.

Abstract

Endometriosis, while commonly managed by gynecologists, is rarely encountered by general surgeons and is often identified incidentally or upon histopathological examination. This condition can manifest in both pelvic and extrapelvic sites, with extrapelvic endometriosis most frequently observed in the gastrointestinal tract and abdominal wall. Cesarean scar endometriosis (CSE) is the most prevalent form of abdominal wall endometriosis. Cyclical symptoms linked to menstruation occur in around half of patients and should raise suspicion in cases presenting with scar-related or subcutaneous swellings. This report presents two cases of extrapelvic endometriosis: one involving appendiceal endometriosis, which was unexpectedly identified as appendicitis, and another with CSE, diagnosed after surgical excision of a painful swelling in the cesarean section scar. The discussion focuses on the diagnosis and management of CSE and appendiceal endometriosis.

摘要

子宫内膜异位症虽然通常由妇科医生诊治,但普通外科医生很少遇到,且常为偶然发现或经组织病理学检查才得以确诊。这种病症可出现在盆腔和盆腔外部位,其中盆腔外子宫内膜异位症最常见于胃肠道和腹壁。剖宫产瘢痕子宫内膜异位症(CSE)是腹壁子宫内膜异位症最常见的形式。约半数患者会出现与月经相关的周期性症状,对于出现瘢痕相关或皮下肿胀的病例应提高警惕。本报告介绍了两例盆腔外子宫内膜异位症病例:一例为阑尾子宫内膜异位症,最初被误诊为阑尾炎;另一例为CSE,在对剖宫产瘢痕处疼痛性肿胀进行手术切除后确诊。讨论重点在于CSE和阑尾子宫内膜异位症的诊断与治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9066/12360736/680a7820f9d0/cureus-0017-00000088319-i01.jpg

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