Endometriosis umbilical secundaria a cirugía laparoscópica previa.

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    • Alternate Title:
      Umbilical endometriosis secondary to previous laparoscopic surgery.
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    • Abstract:
      BACKGROUND: Umbilical endometriosis is a rare disorder; However, it is the most common form of cutaneous endometriosis. It can be caused by surgical interventions, so it is important to include it in the differential diagnosis of umbilical nodule, especially if it appears in a previous scar of laparoscopy or laparotomy. CLINICAL CASE: Patient of 45 years, nulliparous, in follow-up in the General Gynecology department for dysmenorrhea, oligometrorrhagia and painful umbilical nodule. He reported umbilical bleeding, which coincided with his menstrual period. Medical history of interest: laparoscopic right ovarian cystctomy 9 years ago by endometrioma. Currently with irregular cycles and cyclic dysmenorrhea, in treatment with desogestrel. On physical examination a small nodule was palpated in the umbilical region. Transvaginal ultrasound showed the uterus in a position of anteversion, with secretory endometrium and a suggestive image of 1 cm endometrial polyp. Abdominal ultrasound reported a well-defined nodule in the 9 mm retroumbilical region, compatible with secondary umbilical endometriosis, as it was located in the umbilical port scar of the previous laparoscopy. It was decided to perform hysterectomy with double anexectomy and resection of the umbilical nodule. The surgery was carried out without incident. After one month after surgery, the medical evaluation reported good general condition, cessation of pain and oligometrorrhagia, and correct healing of the umbilical wound. CONCLUSION: Endometriosis is an underdiagnosed disease, associated with poor quality of life. After some gynecological intervention, the protected extraction of the surgical pieces is important, due to the possibility of secondary endometriosis. [ABSTRACT FROM AUTHOR]
    • Abstract:
      ANTECEDENTES: La endometriosis umbilical es una alteración poco frecuente; no obstante, es la forma más común de endometriosis cutánea. Puede originarse debido a intervenciones quirúrgicas, por lo que es importante incluirla en el diagnóstico diferencial de nódulo umbilical, principalmente si aparece en una cicatriz previa de laparoscopia o laparotomía. CASO CLÍNICO: Paciente de 45 años, nulípara, en seguimiento en el servicio de Ginecología general por dismenorrea, oligometrorragia y nódulo umbilical doloroso. Refirió sangrado umbilical, que coincidió con el periodo menstrual. Antecedentes médicos de interés: quistectomía laparoscópica del ovario derecho 9 años antes por endometrioma. Actualmente con ciclos irregulares y dismenorrea cíclica, en tratamiento con desogestrel. En la exploración física se palpó un nódulo pequeño en la región umbilical. La ecografía transvaginal evidenció al útero en posición de anteversión, con endometrio secretor y una imagen sugerente de pólipo endometrial de 1 cm. La ecografía abdominal reportó un nódulo debidamente delimitado en la región retroumbilical, de 9 mm, compatible con endometriosis umbilical secundaria, pues se localizaba en la cicatriz del puerto umbilical de la laparoscopia previa. Se decidió la histerectomía con doble anexectomía y resección del nódulo umbilical. La cirugía se llevó a cabo sin contratiempos. Después de un mes posquirúrgico, la valoración médica reportó buen estado general, cese del dolor y de la oligometrorragia, y cicatrización correcta de la herida umbilical. CONCLUSIÓN: La endometriosis es una enfermedad infradiagnosticada, asociada con mala calidad de vida. Después de alguna intervención ginecológica es importante la extracción protegida de las piezas quirúrgicas, debido a la posibilidad de endometriosis secundaria. [ABSTRACT FROM AUTHOR]
    • Abstract:
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