Hepatic endometriosis (original) (raw)

Hepatic pedicle endometriosis: Case report and review of the literature

Journal of Obstetrics and Gynaecology Research, 2019

The localization of endometriotic disease in the hepatic pedicle has never been reported to date. We report the first case of a 67-year-old postmenopausal patient having presented an endometriotic lesion in the hepatic pedicle. A surgical biopsy was needed to confirm the diagnosis after a first radiologic biopsy that concluded the presence of a mucinous cystic tumor with low-grade dysplasia. Medical treatment with aromatase inhibitors was carried out because of the inextirpable nature of the lesion. The diagnosis and therapeutic management of this rarely occurring lesion of atypical localization in a postmenopausal patient is presented here. A review of the literature on this localization could have led to a damaging surgical treatment due to the different diagnoses suggested. Management of endometriosis relies on a multidisciplinary approach that each practitioner must know how to broach with patients of all ages.

Intrahepatic endometriosis as differential diagnosis: Case report and literature review

World Journal of Gastroenterology, 2013

Author contributions: Fluegen G designed the report and analyzed and interpreted the data; Fluegen G, Kroepil F, Knoefel WT and Topp SA were attending doctors of the patient; Topp SA performed the operation; Jankowiak F performed pathological examinations; Zacarias Foehrding L, Knoefel WT and Topp SA critically revised the report and gave important intellectual input.

Laparoscopic management of hepatic endometriosis: Report of two cases and review of the literature

Journal of Minimally Invasive Gynecology, 2005

Hepatic endometriosis is rare. Only 15 cases have been reported in the literature. All 15 were treated by laparotomy. We report two additional cases of hepatic endometriosis managed for the first time laparoscopically. Endometriosis is a progressive disease especially in women of reproductive age. One of the differential diagnoses of liver endometriosis is malignancy. Currently, there are no reports in the literature regarding complications arising from the progression of hepatic endometriosis. However, this lack of evidence does not deny its existence.

Extra-pelvic endometriosis presenting as recurrent hepatic cyst: case report and literature review

International Surgery Journal

Hepatic endometriosis is a very rare form of endometriosis first described by Rokitansky in 1986. To our knowledge, 42 cases of hepatic endometriosis have been reported in the literature till date. The condition offers a diagnostic challenge owing to its variable presentation on imaging and the need for histological and immunohistochemical evidence for a definite diagnosis. We hereby present the 43rd case of ectopic endometrium in the liver of a 30 years old, multiparous female who presented with fever and pain in the right hypochondrium. Radiological imaging suggested a cystic lesion which was managed laparoscopically. Histopathology and immunohistochemistry findings came out to be consistent with endometriosis. The case highlighted the importance of considering endometriosis as a differential in all women irrespective of age and previous history of endometriosis.

Abdominal Wall Endometriosis: Purpose of a Case and Review of Literature

Journal of Gynecology and Obstetrics, 2020

Endometriosis of the abdominal wall is defined as the presence of superficial ectopic endometrial tissue to the parietal peritoneum, whose origin may be associated with previous gynecological surgical procedures. Its prevalence is low, around 0.03%, being the first isolated case in our institution, its report and bibliographic review was necessary. The following paper is a case report and a brief bibliographic literature review. Endometriosis is defined as the presence of endometrial glands and stroma outside the uterine cavity. The definition includes injuries that may or may not be related to previous surgical procedures. It is associated with cesarean section in 57% and hysterectomy in 17%. We present the case of a 37 years old female patient, with a history of three previous cesarean sections 3, 6 and 10 years ago; who presented a clinical picture of a sensation of a mass in the abdominal wall, accompanied by cyclical pain and mass growth related to menstrual periods. Abdominal ultrasound reported a heterogeneous vascularized 4x5cm mass. She underwent surgery at our institution where an endometrial mass was evidenced that infiltrated the rectus abdominis, later the diagnosis was confirmed with the histopathological study. Abdominal endometriosis is a rare entity in medical practice. A high index of suspicion should be considered in the case of a woman who presents with disabling abdominal pain located in the abdominal wall, with a history of previous gynecological surgical procedures. This pathology can be confused with many other surgical entities; for this reason, resorting to paraclinical studies can be essential in the diagnostic certainty.

Two Cases of Acute Abdominal Intestinal Endometriosis

Journal of Emergency Medicine Case Reports, 2017

Endometriosis is a common gynecologic disease, with an estimated incidence of approximately 15% of all women of reproductive age (1). It is characterized by the presence of endometrial glands and stroma outside the uterine cavity and is usually found in the ovaries, rectovaginal pouch, and pelvic peritoneum. However, extrapelvic sites such as the lungs, urinary tract, and gastrointestinal system are less affected sites (2). The rectosigmoid junction, ileum, and appendix are the most commonly reported regions for intestinal endometriosis (IE) (3). Although IE is usually asymptomatic, it may be presented with acute abdomen findings. Here we present the cases of two IE patients who underwent emergency surgeries. Case Reports Case 1: A 65-year-old woman presented with abdominal pain and nausea for 24 h. She had a history of multiple cesarean sections and hysterectomy. On examination, defense and rebound tenderness were observed at the right lower quadrant of the abdomen. Inflammatory markers including white blood count (WBC) (15.5 K/μL) and c-reactive protein (CRP) (98.4 mg/L) were elevated. On ultrasonography (US), enlarged appendix with a small amount of fluid between the intestines was detected. During surgery, a hyperemic and enlarged appendix caused by a brownish mass in the middle part of the organ was found; therefore, a standard appendectomy was performed. The lesion was histopathologically diagnosed as appendicial endometriosis. The patient was discharged without any complication on the second postoperative day. No recurrence was observed during the follow-up period of 30 months. Case 2: A 35-year-old woman presented with abdominal pain, nausea, vomiting, and obstipation for 3 days. She had a history of cesarean section. Her menstruation was quite painful for the previous 2 years. She also suffered from crampy abdominal pain, especially during the menstrual cycle. On examination, the abdomen was distended, bowel sounds were increased, and rectum was empty. Laboratory ABSTRACT Introduction: Gastrointestinal endometriosis is an uncommon form of extragenital endometriosis. The ileum and appendix are the most affected sites following the rectosigmoid region. Case Report: Clinicopathological findings, diagnostic approaches, and therapeutic outcomes of two intestinal endometriosis patients who presented with acute abdomen findings were reviewed. Conclusion: Although intestinal endometriosis is often difficult to diagnose using imaging methods, cyclic symptomatology and a history of obstetric/gynecologic surgery should alert clinicians to consider this diagnosis. Surgery seems to be the best treatment option and mainly depends on the affected site and clinical presentation.

Endometriosis and the gut

Gut, 1988

Fromti t1e D)ep)artnitiett.s ol Suirg(ry1 atid Pathology, Arrowe lPark Hos,p1ital, Upton, Wirral atnd Delpartmtletnt of Sur,gery, Broa(dgreeti Hos.)pital, Lile(rlpool SIJMMARY Six patients with endometriosis involving the intestine are described and illustrate the variety of symptoms which may occur in this condition, many of which are frequently associated with the more common gastrointestinal illnesses. A correct preoperative diagnosis based on history, clinical examination, radiology, and endoscopy may be difficult to make, and when first discovered at laparotomy endometriosis can easily be mistaken for other inflammatory, or neoplastic processes. A histological diagnosis should always be made before definitive treatment.