腹壁子宫内膜异位症。临床病例及文献复习]。

L Calabrese, O Delmonte, R Mari
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摘要

作者报告一个临床病例子宫内膜异位症的腹部直肠肌肉,在妇女28岁,剖宫产后分娩。本文在查阅相关文献的基础上,结合本病的发病率、发病机制、临床特点以及可能有助于诊断和正确治疗的方面进行分析。子宫内膜异位症是一种极为罕见的疾病,在女性人群中的发病率为0.03-1%。发病机制尚不清楚。缺乏典型症状和不寻常的部位可能使诊断困难。病理特征,但并不总是存在的腹壁肿胀可触及附近的手术疤痕,疼痛症状的周期性特征,体积增大和月经期或经前出血。超声检查、计算机轴位体层摄影、核磁共振检查可以促进术前诊断,但它们并不总是提供确定性的报告。超声控制中的抽吸针可提供定位诊断之一。确定的诊断建立在活检或切除后的组织学检查上。腹壁子宫内膜异位症的治疗是手术必不可少的。肿胀的切除,通常是容易的,它是获得彻底恢复的唯一手段。药物治疗术后辅助治疗未识别盆腔中心子宫内膜异位症。
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[Endometriosis of the abdominal wall. Clinical case and review of literature].

The authors report a clinical case of endometriosis the abdomen rectum muscle, in woman 28 years old, after a cesarean section delivery. On the basis of literature on the topic, the following are taken into consideration, the incidence, the pathogenesis, the clinical characteristics of this kind of pathology and the aspects which might facilitate the diagnostic approach and correct therapeutic to be given or follow. Parietal endometriosis is an extremely rare disease with incidence in feminine population of 0.03-1%. The pathogenesis is still ill-known. Lack of the classical symptoms and the unusual site can make diagnosis difficult. Pathognomonics but not always present are the presence of tumescence palpable of the abdominal wall near or proximity of preceding surgical scar, the cyclic character of painful symptomatology, the augmentation of volume and the bleeding in period menstrual or premenstrual. The ultrasonography, the computerized axial tomography, the nuclear magnetic resonance can facilitate the preoperative diagnosis but they do not always furnish reports of certainty. The aspirate-needle in ultrasonography control can furnish one of orientation diagnosis. The diagnosis of certainty is founded on the histologic examination after biopsy or excision. The treatment of the abdominal wall endometriosis is surgically essential. The excision of tumescence, easy usually, it is the only means to obtain the definitive recovery. The medical therapy postoperative is adjuvant in the treatment of unrecognized pelvic centres of endometriosis.

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