Anales de la Facultad de Ciencias Médicas (Asunción)
Print ISSN 1816-8949
ABSTRACT Introduction: Endometriosis is defined as the presence of endometrial tissue outside of the uterus. The usual location is intrapelvic but it can occur elsewhere rarely i.e. in the abdominal wall, where it can be primary or more often secondary to gynecological or obstetrical surgeries, especially caesareans. Objective: To present a typical case of secondary endometriosis of the abdominal wall. Material and Methods: Descriptive. This is a case report and a brief bibliographical revision of the subject. Discussion: The endometriosis of the abdominal wall generally occurs secondarily to gynecologic or obstetric surgeries, most often caesarean. It appears as masses located at the abdominal wall with symptoms that are exacerbated during the menstrual period. The clinic orientates the diagnosis that can be confirmed in the preoperative stage with the cytological study of the material obtained by fine-needle aspiration biopsy. Imaging studies determine the extension degree of the process, helping to plan the surgical act that consists in a wide excision and reconstruction of the wall with or without prosthetic material as needed. This is the case of a female patient, with records of a caesarean five years ago and a tumor at the abdominal wall of three years of evolution that presented increased size and localized pain coinciding with menstruation. The ultrasound showed a poorly demarcated, isoechogenic and solid mass. The computed tomography showed a tumor located in the anterior face of the rectus abdominis muscle without compromise of the cavity. She was operated in the IPS Hospital of Luque with the presumptive diagnosis of wall endometriosis. A wide excision and reconstruction of the wall with a prosthetic mesh were made and the anatomopathological study of the piece confirmed the diagnosis. Conclusions: The presence of a tumor in the abdominal wall with volumetric and symptomatic changes related to menstrual periods strongly suggests the diagnosis of endometriosis of the abdominal wall. Imaging studies allowed determining the commitment of the affected structures and defining the surgery, which is the election treatment with a wide excision
Keywords: endometriosis; abdominal wall; diagnosis and treatment.
Facultad de Ciencias Médicas. Universidad Nacional de Asunción
Dr. José P. Montero e/ Dr. Mario Mazzei
C.P. 1120 Asunción - Paraguay
Tel.: 0595 021 420187