Endometriosis in a post-laparoscopic scar – case report and literature review

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Ginekol Pol. 2014, 85, 386-389

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ginekologia

Endometriosis in a post-laparoscopic scar – case report and literature review

Endometrioza w bliźnie po laparoskopii – analiza sytuacji i przegląd piśmiennictwa

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Department of Maternal and Child Health, University of Medical Sciences, Poznan, Poland

Abstract

Endometriosis is an estrogen-dependent, chronic disease consisting in implantation and hyperplasia of the endo- metrium outside of the uterine cavity. Endometriosis in post-laparoscopic scars applies to approx. 0.5-1% of the extraorganic locations of the disease.

The purpose of the paper was to describe medical management and literature review for endometriosis in a po- st-laparoscopic scar. Two lesions located near the insertion site for the lower trocars were removed along with the border of healthy tissue. At the time of publication of this paper the patient did not report any complaints.

In conclusion, each limited lesion in the subcutaneous tissue, with pain intensifying during menstruation, should suggest an initial diagnosis of scar endometriosis, regardless of patient age and type of surgery.

Key words: endometriosis / scar endometriosis / laparoscopy / homeostasis /

Streszczenie

Endometrioza jest estrogenozależną, chorobą przewlekłą, polegającą na implantacji i rozroście endometrium poza jamą macicy. Endometrioza w bliźnie po operacjach laparoskopowych dotyczy około 0,5-1% zewnątrznarządowej lokalizacji choroby.

Celem pracy był opis postępowania medycznego i przeglądu piśmiennictwa w sytuacji występowania endometriozy w bliźnie po laparoskopii. Dwie zmiany, zlokalizowane w okolicy wkłucia dolnych troakarów, zostały usunięte w gra- nicach zdrowych tkanek. W chwili obecnej pacjentka nie zgłasza żadnych dolegliwości.

Podsumowując, każda ograniczona zmiana w tkance podskórnej, której ból nasila się w trakcie miesiączki, powin- na sugerować wstępne rozpoznanie endometriozy w bliźnie, niezależnie od wieku pacjentki i rodzaju wykonanej operacji.

Słowa kluczowe: endometrioza / endometrioza Z EliĨnie / laparoskopia / hemostaza /

Otrzymano: 12.08.2013

Zaakceptowano do druku: 30.10.2013 Corresponding author:

Karolina Chmaj-Wierzchowska,

Department of Maternal and Child Health, University of Medical Sciences, Poznan, Poland, Polna str. 33, 60-535 Poznań

tel./fax: +48 61 841 92 71 e-mail: karolinachmaj@poczta.onet.pl

© P o l s k i e T o w a r z y s t w o G i n e k o l o g i c z n e

Nr 5/2014

387

P R A C E K A Z U I S T Y C Z N E ginekologia Ginekol Pol. 2014, 85, 386-389

Karolina Chmaj-Wierzchowska et al. Endometriosis in a post-laparoscopic scar – case report and literature review.

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Table I. Review of the medical literature concerning complications following laparoscopic procedures.

Author: Year Patient

age

Previous surgery (laparoscopy)

Time interval (months)

Location of complication

Denton G [23] 1990 37 sterilization 12 Umbilical area

Healy J [27] 1995 23 diagnostic 9 Umbilical area

Martínez-Serna T [28] 1998 35 diagnostic/laparotomy 11 Suprapubic area

Majeski J [24] 2004 44 myomectomy 84 Umbilical area

Akbulut S [26] 2010 30 cyst resection 4 Right trocar

Song J [29] 2011 45 supracervical hysterectomy 24 Suprapubic area

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P R A C E K A Z U I S T Y C Z N E

ginekologia Ginekol Pol. 2014, 85, 386-389

Karolina Chmaj-Wierzchowska et al. Endometriosis in a post-laparoscopic scar – case report and literature review.

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Figure 1. Two endometrial foci, measuring: 3x3 cm and 6x3 cm (Figs. 2 and 3).

Figure 2. Endometrial tumor in a scar after the lower trocar, on the median body line, measuring approx. 3x3 cm.

Figure 3. Endometrial tumor measuring approx. 6 cm in diameter, on the medial line of the hypogastrium, in a scar following the lower trocar.

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Nr 5/2014

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P R A C E K A Z U I S T Y C Z N E ginekologia Ginekol Pol. 2014, 85, 386-389

Karolina Chmaj-Wierzchowska et al. Endometriosis in a post-laparoscopic scar – case report and literature review.

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Oświadczenie autorów

1. Karolina Chmaj-Wierzchowska – autor koncepcji i założeń pracy, przygotowanie manuskryptu i piśmiennictwa - autor zgłaszający i odpowiedzialny za manuskrypt.

2. Beata Pięta – ostateczna weryfikacja i akceptacja manuskryptu.

3. Tomasz Czerniak – ostateczna weryfikacja i akceptacja manuskryptu, przechowywanie dokumentacji.

4. Tomasz Opala – ostateczna weryfikacja i akceptacja manuskryptu.

Źródło finansowania: Praca nie była finansowana przez żadną instytucję naukowo-badawczą, stowarzyszenie ani inny podmiot, autorzy nie otrzymali żadnego grantu.

Konflikt interesów: Autorzy nie zgłaszają konfliktu interesów oraz nie otrzymali żadnego wynagrodzenia związanego z powstawaniem pracy.

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