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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 44-year-old female was initially evaluated for a 3-cm umbilical hernia, which developed after a laparoscopic myomectomy performed seven years prior. The umbilical hernia was repaired using a synthetic mesh. Eight months after the umbilical hernia repair, the patient returned with chronic pain in a 3-cm raised mass originating from the umbilical hernia repair incision. The mass and mesh were surgically removed. The umbilical fascial defect was repaired with a primary fascia-to-fascia closure and the umbilicus was reconstructed from adjacent skin. The mass was found histologically to be endometriosis and fascial scarring with a foreign body reaction to synthetic mesh. Umbilical endometriosis developed either from peritoneal endometrial seeding from a laparoscopic myomectomy or from metaplasia of multipotential cells, which developed into endometriosis due to inflammatory stimulation by the synthetic mesh. Synthetic mesh probably should be avoided in the surgical repair of a laparoscopically caused umbilical hernia in a premenopausal female especially if there is a history of pelvic endometriosis.
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PMID:Scar endometriosis developing after an umbilical hernia repair with mesh. 1518 34

We report a case of endometriosis of the round ligament in a 29-year-old woman, who complained of a lump with a diameter of about 2.5 cm in the right inguinal region, which increased in bulk and was accompanied by intense pain during the menstrual period. The clinical suspicion of inguinal endometriosis, supported by ultrasonography and Magnetic Resonance (MR), was confirmed by histological examination of the surgical specimen, which included the mass and the extraperitoneal segment of the round ligament. The authors conclude that the appearance of a lump in the inguinal region associated with subjective and objective changes of the lesion in relation to the menstrual cycle must raise the suspicion of endometriosis among the possible diagnoses.
Hernia 2005 Oct
PMID:Endometriosis of the round ligament: description of a clinical case and review of the literature. 1570 60

A 26-year-old nulliparous woman underwent a laparoscopy to remove a 10-cm endometrial cyst on the left ovary (type II Nezhat). The cyst was extracted from the 10-mm umbilical incision; the other 2 trocars were inserted through 5-mm incisions. One year later, in correspondence to the previous 5-mm incision site, a hernia occurred that contained omentum and was reduced easily with a local anesthetic. After 2 years of good health, an aching nodule occurred on the same trocar site; vaginal ultrasound examination showed another left ovarian cyst. A second laparoscopy was performed; the cyst was very adherent and was removed in fragments. The wall nodule was removed, and the histologic examination classified it as endometriosis.
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PMID:Incisional hernia on the 5-mm trocar port site and subsequent wall endometriosis on the same site: a case report. 1615 Feb 94

Scar endometrioma is an uncommon condition following caesarean section. It presents as a lump on the caesarean scar and can often be painful. Endometrioma is referred to the general surgeon as an incisional hernia. We present six such patients referred to the general surgical department by either the general practitioner or the gynaecologist. Scar endometrioma is believed to arise due to implantation of endometrial tissue during caesarean section. Cyclical pain, as in endometriosis, is characteristic but uncommon. Local wide excision remains the treatment of choice.
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PMID:Post-caesarean incisional hernia or scar endometrioma? 1745 Jun 97

Extrapelvic endometriosis in an abdominal wall surgical scar is a rare entity that is difficult to diagnose. However, it should be suspected in any woman of childbearing age complaining of a cyclic painful nodule in a scar from a previous obstetric or gynecologic procedure, after excluding other conditions such as incisional hernia, late abscess, or suture granuloma. Fine-needle aspiration biopsy provides an accurate preoperative diagnosis. Imaging studies such as ultrasound, computed tomography, or magnetic resonance imaging are non-specific, but may be helpful in identifying the exact anatomical location of the lesion and in excluding other surgical conditions. We present two cases of endometriosis in an abdominal wall scar that developed after cesarean section performed 7 years previously. In both patients, preoperative diagnosis, based on clinical suspicion in the first patient and aspiration cytology in the second, was correct. Wide local excision was curative in both patients.
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PMID:[Endometriosis in a laparotomic scar after cesarean section: report of two cases]. 1675 23

Endometriosis is a common gynaecological condition; cutaneous endometriosis is a subtype of endometriosis. Although cutaneous endometriosis involving the abdominal wall is not common, preoperative diagnosis of cutaneous endometriosis can be easily mistaken for a suture granuloma, lipoma, abscess, cyst or hernia. We report two common surgical presentations of this gynaecological condition.
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PMID:Cutaneous endometriosis--Surgical presentations of a gynaecological condition. 1709 9

Endometriosis is a common gynecologic condition and has been described in several locations, mostly in the pelvis. Extragenital endometriosis may appear as a painful nodule evoking an inguinal hernia. Scar endometriosis after inguinal hernia repair seems to be a rare occurrence. We report an unusual case of a 28-year-old woman who developed a scar endometriosis 2 years after an inguinal hernia repair. This case highlights that the presence of a painless inguinal mass similar to a recurrent hernia, with possible swelling related to the menstrual cycle, may evoke endometriosis, especially after a previous hernia repair and should lead to prompt diagnosis, wide excision, and gynecological advice.
Hernia 2007 Apr
PMID:Endometriosis mimicking hernia recurrence. 1711 56

We report a rare case of primitive umbilical endometriosis associated with umbilical hernia, which required wide umbilical resection and immediate reconstruction performed according to a recently described technique. A wide resection of the peritoneal sac was performed because of the possible presence of endometrial tissue inside. The hernia was repaired according to Mayo's technique. Umbilical reconstruction was performed using two semicircular skin flaps shaped into in an ellipse preoperatively drawn on the skin with a vertical orientation. The surgical approach described in this report allowed easy hernia repair and umbilical reconstruction. No prosthesis was used because of the small size of the hernia and lack of literature data on prosthesis use in endometriosis. The aesthetic result was considered satisfactory 6 months after the operation because of absence of hypertrophic scars and in view of the anatomical aspect of the new umbilicus. No recurrence was observed within this time frame.
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PMID:Umbilical endometriosis associated with umbilical hernia. Management of a rare occurrence. 1836 Oct

Obturator neuralgia (ON) presents with pain in the groin, medial thigh, and sometimes the medial aspect of the knee. The causes include trauma, obturator hernia, pelvic cancer, pelvic surgery, hip surgery, following pelvic fractures, endometriosis, retroperitoneal hematoma, pregnancy, and delivery. Ultrasound (US) guidance facilitates real-time imaging, identification of vascular structures, and improves patient comfort in situations where nerve stimulation can be unpleasant. This is a case report of ON successfully treated with US-guided steroid injection. A 55-year-old man was referred to the pain clinic with groin pain and allodynia in the medial thigh and knee following a fall. He had tried multiple other therapies and none of them provided significant relief. Using a 10-5-MHz multi-frequency, 38-mm linear array transducer, the obturator nerve was scanned in both longitudinal and transverse directions. Under real-time imaging 10 mg of medroxy-progesterone in a volume of 1 mL was injected. Following the injection, a small area of the medial side of knee was still tender to light touch. A second injection was placed inferiorly and provided pain relief for more than 5 months. This successful demonstration of US guidance in ON may further encourage US guidance in pain clinic interventions.
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PMID:Ultrasound-guided steroid injection for obturator neuralgia. 1850 24

Three cases of endometriosis infiltrating the round ligament are presented. The initial diagnosis was irreducible hernia, since this rare nosologic entity often causes unusual preoperative symptoms and diagnostic problems. Diagnosis is frequently made by histologic examination. The rarity of inguinal endometriosis should not exclude it from a possible diagnosis in cases with a painful mass in the inguinal region in a fertile woman, especially if the groin mass is associated in size and tenderness with menstrual variability. Surgery is the treatment of choice and is curative; laparoscopy is suggested during the same operation to evaluate the intraperitoneal conditions.
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PMID:Inguinal endometriosis: three cases and literature review. 1913 3


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