Extra-gonadal endometriosis : unusual presentation

Abstract EN

Background: Extra-gonadal Endometriosis is a rare entity.

It is rarely reported from this region.

Objective: To present six cases of unusual extra-gonadal endometriosis.

Design: Retrospective review Setting: Surgical Department, Salmaniya Medical Complex, Kingdom of Bahrain.

Method: Six patients with extra-gonadal endometriosis who presented to the surgical department during a period of three years (between 2002 –2005) were reviewed.

Result: The patients were females with age ranging between 29 and 48 years.

Three patients presented with painful umbilical mass and bleeding during menses.

One patient had a painful nodule in her lower segment caesarian section scar; another had endometrioma of the appendix and one presented with acute small bowel obstruction.

All had regular menstrual cycle.

The majority had associated menorrhagia and dysmenorrhea but did not have any significant past gynecological history.

CT scan in three patients confirmed the presence of umbilical nodule or mass but was not helpful in reaching the diagnosis pre-operatively.

In the other three cases, preoperative investigations were not helpful in reaching the definitive diagnosis.

The management in all the cases was complete resection.

Histopathology confirmed the diagnosis.

Conclusion: Six cases of extra-gonadal endometriosis with unusual presentation had been reviewed and presented in this study.

Extra-gonadal endometriosis is a rare condition presenting to the general surgeon.

Clinical awareness is more important in diagnosis than radiological findings.

Complete surgical resection is the rule in all cases.