Endométriose extra-génitale : atteinte pariétales, thoraciques, diaphragmatiques et nerveuses. RPC Endométriose CNGOF-HAS

Merlot, Benjamin; Ploteau, Stéphane; Abergel, A.; Rubob, C.; Hocké, C.; Canis, Michel; Fritel, Xavier; Roman, Horace; Collinet, Pierre

doi:10.1016/j.gofs.2018.02.001

Cited by 5 publications

(6 citation statements)

References 40 publications

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“…Ultrasound of abdominal wall with a high frequency probe is the initial, easily accessible examination that points to the diagnosis of umbilical endometriosis, but it is not pathognomonic. It confirms the presence of an umbilical nodule, specifies its size, its contours, its limits with the adjacent superficial and deep structures, its homo or heterogeneous content, its solid or cystic nature [8].…”

Section: Discussionmentioning

confidence: 60%

Umbilical endometriosis: A case report

Sabiri,

Gourja,

Benrahal

et al. 2023

Edorium J Gynecol Obstet

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Introduction: Cutaneous and umbilical involvement is very rare and represents only 0.5–1% in the various series. Its clinical diagnosis is difficult but it should be suspected in the presence of any bluish, painful umbilical nodule, sometimes with a brownish discharge, the evolution regulated by the menstrual cycle. Ultrasound of the abdominal wall points to the diagnosis of umbilical endometriosis despite the absence of characteristic signs on imaging. Wide surgical excision is the treatment of choice because of its resemblance to a primary tumor or metastasis. Case Report: We report the case of a 31-year-old female patient with no history of abdominal-pelvic surgery or trauma to the umbilicus, consulted for a painful umbilical swelling measuring approximately 1–2 cm diagnosed with umbilical endometriosis. Endometriosis of the umbilical wall is a rare condition, representing only 0.03–2% of extra-genital endometriosis. It is associated with pelvic endometriosis in 26% of cases. Its clinical diagnosis is difficult but it should be suspected in the presence of any bluish, painful umbilical nodule, sometimes with a brownish discharge, the evolution regulated by the menstrual cycle. Ultrasound of the abdominal wall with a high frequency probe is the initial, easily accessible examination that points to the diagnosis of umbilical endometriosis, but it is not pathognomonic. The formal diagnosis of umbilical endometriosis is only obtained with the help of histological examination. The presence of endometrial glands (epithelial cells) and a cytogenic chorion in the ectopic endometrial tissue is necessary to establish the histological diagnosis. In general, medical treatment with danazol, norethisterone, or luteinizing hormone-releasing hormone (LHRH) analogues is recommended before surgery. It would allow a reduction in the size of the endometriotic nodules. Conclusion: Umbilical endometriosis is a very rare form of extra-genital endometriosis. The diagnosis is made when a nodule is present with pain and catamenial bleeding. The diagnosis of certainty is based on a histological study.

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Section: Discussionmentioning

confidence: 60%

Umbilical endometriosis: A case report

Sabiri,

Gourja,

Benrahal

et al. 2023

Edorium J Gynecol Obstet

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“…Parietal endometriotic lesions usually occur in women with a history of uterine surgery (caesarean section, hysterectomy, myomectomy) or can develop de novo (umbilicus or inguinal canal). The relative merits of surgical treatment versus medical hormonal therapy administered before, after or instead of surgical treatment cannot be assessed from the data in the literature [19].…”

Section: Extrapelvic Endometriosis: Parietal Diaphragmatic Thoracicmentioning

confidence: 99%

“…Deep endometriosis can compress or infiltrate the sacral roots or the sciatic nerve trunk, leading to cyclic symptoms involving the somatic nervous system (sciatic or pudendal nerve territories) or the autonomic nervous system (bladder, colorectal or vaginal symptoms) (LoE3). Several case series reported by centres of excellence have noted the efficacy of surgery against pain (LoE4) [19]. The relative merits of surgical treatment versus medical hormonal therapy administered before, after or instead of surgical treatment cannot be assessed from the data in the literature.…”

Section: Endometriosis Of Nerve Roots and The Sciatic Nervementioning

confidence: 99%

Management of endometriosis

Collinet

Fritel

Revel-Delhom

et al. 2018

Journal of Gynecology Obstetrics and Human Reproduction

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First-line diagnostic investigations for endometriosis are physical examination and pelvic ultrasound. The second-line investigations are: targeted pelvic examination performed by an expert clinician, transvaginal ultrasound performed by an expert physician sonographer (radiologist or gynaecologist), and pelvic MRI. Management of endometriosis is recommended when the disease has a functional impact. Recommended first-line hormonal therapies for the management of endometriosis-related pain are combined hormonal contraceptives (CHCs) or the 52mg levonorgestrel-releasing intrauterine system (IUS). There is no evidence base on which to recommend systematic preoperative hormonal therapy solely to prevent surgical complications or facilitate surgery. After surgery for endometriosis, a CHC or 52mg levonorgestrel-releasing IUS is recommended as first-line treatment when pregnancy is not desired. In the event of failure of the initial treatment, recurrence, or multiorgan involvement, a multidisciplinary team meeting is recommended, involving physicians, surgeons and other professionals. A laparoscopic approach is recommended for surgical treatment of endometriosis. HRT can be offered to postmenopausal women who have undergone surgical treatment for endometriosis. Antigonadotrophic hormonal therapy is not recommended for patients with endometriosis and infertility to increase the chances of spontaneous pregnancy, including postoperatively. Fertility preservation options must be discussed with patients undergoing surgery for ovarian endometriomas.

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“…Endometriosis lesions located in the abdominal area are found predominantly in the pelvic area and, less frequently, in the upper abdomen. They are found only rarely in extra-abdominal organs such as lungs, skin, or the spinal cord (1, 31,32,33,36,37,40).…”

Section: Introductionmentioning

confidence: 99%