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CC BY 4.0 · European J Pediatr Surg Rep. 2020; 08(01): e10-e13
DOI: 10.1055/s-0039-1700987
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Primary Umbilical Endometriosis in an Adolescent Girl: Unsuspected Pathology

Leel Nellihela 
1   Department of Paediatric Surgery, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
,
Mudher Al-Adnani
2   Department of Histopathology, Evelina London Children's Hospital, Guy's and St Thomas NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
,
Dorothy Kufeji
1   Department of Paediatric Surgery, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
› Author Affiliations
Further Information

Publication History

18 May 2019

19 November 2019

Publication Date:
08 February 2020 (online)

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Abstract

Endometriosis affects 7 to 10% of women of reproductive age. Primary umbilical endometriosis (PUE) is even rarer with unclear pathogenesis. We report a case of PUE possibly the youngest patient reported in the literature.

A 16-year-old girl of African origin presented with painful umbilical lump for 2 to 3 months duration with background history of precocious puberty, cyclical vomiting, and menorrhagia. Clinical examination showed dark-colored, tender, irreducible umbilical lump. A provisional diagnosis of incarcerated umbilical hernia was made. Abdominal X-ray showed no features of intestinal obstruction. Ultrasound scan of the abdomen showed lump containing heterogeneous echogenic material measuring 2.0 × 1.5cm within the umbilicus with no visible bowel loops or peristalsis. This was reported as consistent with an umbilical hernia with narrow neck possibly containing mesentery or intra-abdominal fat. The patient underwent urgent exploration of umbilicus under general anesthetic. At operation, a dark-colored, firm mass was excised and sent for histology. The underlying fascia and peritoneum were repaired.

Histological examination confirmed the excised tissue was endometriosis. Follow-up continues in the endometriosis clinic.

Umbilical endometriosis should be considered in differential diagnoses of painful umbilical lesion in adolescent girls and women of reproductive age. Complete excision and histology are highly recommended for obtaining a definitive diagnosis, to exclude malignancy and to prevent recurrence.

Keywords

endometriosis - umbilical - primary - adolescent
 

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