Objective.Parietal endometriosis is an uncommon pathology. It can occur on all the scars, most often after a surgical procedure with hysterotomy. Surgical scar endometriosis following caesarean section has an incidenc...Objective.Parietal endometriosis is an uncommon pathology. It can occur on all the scars, most often after a surgical procedure with hysterotomy. Surgical scar endometriosis following caesarean section has an incidence of 0.03 to 0.4% . Patients and methods.- This retrospective study reviewed all the cases of parietal endometriosis seen during a 7- year period in the department of visceral surgery of the Armentiè re’ s hospital center. A pathological analysis has confirmed each lesion retained. Results.- 15 women were treated during this period. The mean age is 32 years. All the women have one or two antecedents of caesarean with Pfannenstiel’ s laparotomy. The interval between the caesarean and the appearance of the first symptoms is on average of 5 years and 11 months. Only 66.6% of cases presented the classical symptoms with cyclic pain. For 66.6% of patients, the diagnosis of parietal endometriosis was suspected before the treatment. The treatment is a surgical one with exeresis for all the women. In 13.3% of the cases, the lesion is pre aponeurotic. In 46.6% of the cases, it overgrows the rectus abdominis muscle, in 33.3% of the cases the external abdominal oblique and at last a lesion overgrows the transversus abdominis and one is in an inguinal localization. The mean size of lesions is 2.48 cm. We have not notified complications and no recurrence was noted. Discussion and conclusion.- The local endometrial cell transplant is the most likely mechanism to explain the physiopathology of parietal endometriosis. The classical symptoms associate a painful swelling and cyclic pain related to the menstrual period, but all of these symptoms are not always associated. The contribution to the diagnosis of the imaging studies is weak. The surgical treatment has to be sufficiently wide to avoid all recurrence. No means of prevention has proved its efficiency. In 26.6% of cases the parietal endometriosis is associated to pelvic endometriosis. This localization is more often asymptomatic. Then the realization of a laparoscopic exploration is not indicated immediately.展开更多
Heterotopic pancreas （HP） is a congenital anomaly defined as pancreatic tissue that has no contact with the orthotopic pancreas and its own duct system and vascular supply. The most common locations of HP are the up...Heterotopic pancreas （HP） is a congenital anomaly defined as pancreatic tissue that has no contact with the orthotopic pancreas and its own duct system and vascular supply. The most common locations of HP are the upper gastrointestinal tract, specifically, the stomach, duodenum, and proximal jejunum. In-volvement of the mesentery is rare. Here, we describe a rare case of mesenteric heterotopic pancreas （MHP） in a 12-year-old girl who presented with acute abdomen. The patient underwent emergency laparotomy, and the mass and adjacent small bowel were resected. Results of the postoperative histopathologic examination confirmed the diagnosis of MHP. Observation of the patient for 12 mo postoperatively showed no evidence of recurrence. Preoperative diagnosis of HP is diffcult, even in a symptomatic patient. Increased awarenessand understanding of the image characteristics of MHP will aid in correct preoperative diagnosis and appropriate patient management.展开更多
虽然子宫腺肌病（adenomyosis, AM）从发生、发展、命名、分类等均有诸多不解之惑和未明之争，但人们愈加倾向于 AM 与子宫内膜异位症（endometriosis, EM）应属于同一种病，只由于“异位病变”之部位不同，而形成了不同的类型。较多的...虽然子宫腺肌病（adenomyosis, AM）从发生、发展、命名、分类等均有诸多不解之惑和未明之争，但人们愈加倾向于 AM 与子宫内膜异位症（endometriosis, EM）应属于同一种病，只由于“异位病变”之部位不同，而形成了不同的类型。较多的研究表明，EM与AM的发病机制、临床表现是基本相同的。展开更多
文摘Objective.Parietal endometriosis is an uncommon pathology. It can occur on all the scars, most often after a surgical procedure with hysterotomy. Surgical scar endometriosis following caesarean section has an incidence of 0.03 to 0.4% . Patients and methods.- This retrospective study reviewed all the cases of parietal endometriosis seen during a 7- year period in the department of visceral surgery of the Armentiè re’ s hospital center. A pathological analysis has confirmed each lesion retained. Results.- 15 women were treated during this period. The mean age is 32 years. All the women have one or two antecedents of caesarean with Pfannenstiel’ s laparotomy. The interval between the caesarean and the appearance of the first symptoms is on average of 5 years and 11 months. Only 66.6% of cases presented the classical symptoms with cyclic pain. For 66.6% of patients, the diagnosis of parietal endometriosis was suspected before the treatment. The treatment is a surgical one with exeresis for all the women. In 13.3% of the cases, the lesion is pre aponeurotic. In 46.6% of the cases, it overgrows the rectus abdominis muscle, in 33.3% of the cases the external abdominal oblique and at last a lesion overgrows the transversus abdominis and one is in an inguinal localization. The mean size of lesions is 2.48 cm. We have not notified complications and no recurrence was noted. Discussion and conclusion.- The local endometrial cell transplant is the most likely mechanism to explain the physiopathology of parietal endometriosis. The classical symptoms associate a painful swelling and cyclic pain related to the menstrual period, but all of these symptoms are not always associated. The contribution to the diagnosis of the imaging studies is weak. The surgical treatment has to be sufficiently wide to avoid all recurrence. No means of prevention has proved its efficiency. In 26.6% of cases the parietal endometriosis is associated to pelvic endometriosis. This localization is more often asymptomatic. Then the realization of a laparoscopic exploration is not indicated immediately.
基金Supported by the Outstanding Scientific Fund of Shengjing Hospital,No.m201502
文摘Heterotopic pancreas （HP） is a congenital anomaly defined as pancreatic tissue that has no contact with the orthotopic pancreas and its own duct system and vascular supply. The most common locations of HP are the upper gastrointestinal tract, specifically, the stomach, duodenum, and proximal jejunum. In-volvement of the mesentery is rare. Here, we describe a rare case of mesenteric heterotopic pancreas （MHP） in a 12-year-old girl who presented with acute abdomen. The patient underwent emergency laparotomy, and the mass and adjacent small bowel were resected. Results of the postoperative histopathologic examination confirmed the diagnosis of MHP. Observation of the patient for 12 mo postoperatively showed no evidence of recurrence. Preoperative diagnosis of HP is diffcult, even in a symptomatic patient. Increased awarenessand understanding of the image characteristics of MHP will aid in correct preoperative diagnosis and appropriate patient management.
文摘虽然子宫腺肌病（adenomyosis, AM）从发生、发展、命名、分类等均有诸多不解之惑和未明之争，但人们愈加倾向于 AM 与子宫内膜异位症（endometriosis, EM）应属于同一种病，只由于“异位病变”之部位不同，而形成了不同的类型。较多的研究表明，EM与AM的发病机制、临床表现是基本相同的。
