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BMJ Case Reports 2017; doi:10.1136/bcr-2017-219291
  • Unusual presentation of more common disease/injury
  • CASE REPORT

Port site endometrioma: a rare cause of abdominal wall pain following laparoscopic surgery

  1. Midhat Siddiqui4
  1. 1Student, King's College London School of Medical Education, London, UK
  2. 2Foundation Year 2, Darent Valley Hospital, Dartford, UK
  3. 3Foundation Year 1, Lewisham and Greenwich NHS Trust, London, UK
  4. 4Upper GI Consultant Surgeon, Queen Elizabeth Hospital, London, UK
  1. Correspondence to Midhat Siddiqui, midhat.siddiqui{at}nhs.net
  • Accepted 30 May 2017
  • Published 18 June 2017

Summary

Endometriomas are a rare cause of abdominal wall pain. We report a case of a port site endometrioma presenting with an umbilical swelling. The patient underwent a laparoscopy for pelvic endometriosis 6 months previously and presented with a swelling around her umbilical port site scar associated with cyclical pain during menses. Ultrasound scan reported a well-defined lesion in the umbilicus and MRI scanning excluded other pathology. As she was symptomatic, she underwent an exploration of the scar and excision of the endometrioma with resolution of her symptoms. Precautions should be taken to reduce the risk of endometrial seeding during laparoscopic surgery. All tissues should be removed in an appropriate retrieval bag and the pneumoperitoneum should be deflated completely before removing ports to reduce the chimney effect of tissue being forced through the port site. The diagnosis should be considered in all women of reproductive age presenting with a painful port site scar.

Footnotes

  • Contributors ZS wrote the case report from the notes and discussed the case with MS. He also submitted the paper and helped with proof-reading. FH proof read the case report and wrote the background and summary. ZS did the literature review and, with FH, wrote the discussion. MS is the senior author who proof-read the paper and gave guidance.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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