Incision scar's endometriosis case that was treated with false diagnosis/Yanlis teshis ile tedavi edilmis, bir insizyon skari endometriozisi olgusu

• Published in: European Journal of Therapeutics Vol. 23; no. 3; p. 122
• Main Authors: Karatas, Turgay, Bitirim, Mehmet Altan, Erguvan-Onal, Rezzan, Orman, Ibrahim
• Format: Journal Article
• Language: English
• Published: AVES 01.09.2017
• Subjects: Bacterial infections; Cesarean section; Endometriosis; Health aspects; Hernia; Obstetrics
• ISSN: 2564-7784
• DOI: 10.5152/EurJTher.2017.52

Endometriosis is defined as the placement of a functional endometrium tissue outside the uterine cavity. Abdominal-wall endometriosis is usually observed after obstetric and gynecological operations. Endometriosis masses located in incision scars can be confused with foreign body reaction, granulomas, abscess, and incisional hernia. A 45-year-old female patient, who had undergone cesarean section 14 years ago, presented to our clinic for pain on the left side of the incision for 6 months and particularly because of the painful mass that grew during menstruation in that region. The patient was misdiagnosed as reactive lymphadenopathy due to fungal and bacterial infections in her toes before presenting to our clinic, and she was treated for a long time with this false diagnosis. On the left side of the Pfannen-Stiel incision, a non-mobile, painful mass of about 2x1 cm, with moderate stiffness, was detected on the physiological examination of the patient. Superficial ultrasonography applied to the region showed lobulated contour, mild heterogeneous hypoechoic, and mild vascularized solid lesion sized 10.4x3.4x10 mm on the left side of the incision line. The patient underwent surgery with an initial diagnosis of endometriosis in the incision scar. The received tissue was sent for pathological examination, and she was diagnosed as endometriosis. Thus, if a mass is detected in the anterior wall of the abdomen in women who had undergone cesarean delivery, the possibility of endometriosis should not be overlooked after the patient's history has been cautiously taken and physical examination and radiological examinations have been performed. Keywords: Endometriosis, abdominal-wall's masses, incision scar's endometriosis OZ Endometriosis, fonksiyonel endometrium dokusunun uterus kavitesi disinda yerlesmesi seklinde tanimlanir. Karin duvarindaki endometriosis, genellikle, onceki gecirilmis obstetrik ve jinekolojik ameliyatlardan sonra gorulmektedir. Insizyon skarinda yerlesik olan endometriosis kitleleri, yabanci cisim reaksiyonu, granulomlar, apseler ve insizyonel hernilerle karistirilabilirler. On dort yil once Sezaryen ameliyati olan 45 yasindaki kadin hasta, 6 aydir insizyonun sol tarafinda agri ve ozellikle, o bolgede adet doneminde buyuyen agrili kitle sebebiyle klinigimize basvurdu. Hastaya, bize basvurmadan once, ayak parmaklarinda mantar ve bakteryel infeksiyona bagli reaktif lenfadenopati olarak yanlis tani konmus ve bu yanlis taniyla hasta, uzun sure tedavi edilmisti. Hastanin fizik muyenesinde, Pfannen-Stiel insizyonun sol kisminda, yaklasik 2x1 cm'lik, orta sertlikte, mobil olmayan agrili kitle saptandi. Bolgeye uygulanan yuzeyel ultrasonografide insizyon hattinin sol tarafinda 10,4x3,4x10 milimetre boyutlarinda lobule konturlu, hafif heterojen hipoekoik, hafif vaskularize solid lezyon izlendi. Insizyon skarinda endometriosis on tanisiyla, hasta, ameliyat edildi. Alinan doku patolojik incelemeye gonderildi ve sonuc endometriozis geldi. Sonuc olarak; sezaryen gecirmis kadinlarda, karin on duvarinda kitle saptandiginda, hastanin anamnezi dikkatli bir sekilde alinip, muayene ve tetkikleri yapildiktan sonra endometrisis olasiligi gozardi edilmemelidir. Anahtar kelimeler: Endometriozis, batin duvari kitleleri, insizyon skari endometriozisi