Extrapelvic endometrioma presenting as acute incarcerated right inguinal hernia in a postpartum patient

A 33-year-old postpartum patient, who had an uncomplicated repeat caesarean section 4 weeks prior, presented with a 2-day history of acute right lower quadrant, incisional and groin pain. She was found to have a palpable tender lump in the right groin. A CT scan with contrast identified fluid along...

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Published inBMJ case reports Vol. 12; no. 9; p. e231213
Main Authors Azhar, Erum, Mohammadi, Salma M, Ahmed, Fauzan M, Waheed, Abdul
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 01.09.2019
BMJ Publishing Group
SeriesCase report
Subjects
Abdomen
Abdominal Pain
Abdominal Wall - pathology
Abdominal Wall - surgery
Adult
Case reports
Cesarean Section - adverse effects
Cysts
Diagnosis, Differential
Emergency medical care
Endometriosis
Endometriosis - pathology
Endometriosis - surgery
Female
Gynecology
Hernia, Inguinal - diagnosis
Hernia, Inguinal - pathology
Hernia, Inguinal - surgery
Hernias
Herniorrhaphy
Humans
Infertility
Ligaments
Medical imaging
Pain
Pathogenesis
Pathology
Postpartum Period
Surgeons
Surgery
Treatment Outcome
Ultrasonic imaging
Unusual Presentation of More Common Disease/Injury
Womens health
obstetrics and gynaecology
reproductive medicine
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Summary:A 33-year-old postpartum patient, who had an uncomplicated repeat caesarean section 4 weeks prior, presented with a 2-day history of acute right lower quadrant, incisional and groin pain. She was found to have a palpable tender lump in the right groin. A CT scan with contrast identified fluid along the anterior abdominal wall of the right lower quadrant (inguinal region) measuring about 1.7 cm, a preliminary diagnosis of an incarcerated inguinal hernia was made and the patient underwent immediate surgery. The hernia sac was dissected free and had chocolate cyst that was confirmed to be endometrioma on histopathology. The hernia defect was repaired. Postoperative, the patient did well and was discharged home. We emphasise to consider this differential diagnosis of extrapelvic inguinal endometrioma in reproductive-aged women with or without history of endometriosis especially in a post-caesarean patient who has atypical presentations.
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ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2019-231213