2019, Number 09
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ABSTRACTBackground: 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.
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