Case Report


Surgical management of inguinal endometriosis: Case report and surgical video

,  ,  ,  ,  

1 MD, Resident Physician, Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA

2 MD, Gynecologic Pathology Fellow, Departments of Pathology and Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA

3 MD, Professor; Director of Minimally Invasive and Robotic Surgery, Director of Minimally Invasive Gynecologic Surgery Fellowship, Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA

4 MD, FACOG, Assistant Professor, Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA

Address correspondence to:

Gabriela Beroukhim

MD, 20 York Street, New Haven, CT 06511,

USA

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Article ID: 100136Z08GB2023

doi: 10.5348/100136Z08GB2023CR

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How to cite this article

Beroukhim G, Esencan E, Manrai P, Azodi M, Cho YK. Surgical management of inguinal endometriosis: Case report and surgical video. J Case Rep Images Obstet Gynecol 2023;9(1):11–16.

ABSTRACT


Introduction: Inguinal endometriosis is a rare type of extra-pelvic endometriosis, which may occur in the absence of symptoms of intra-pelvic endometriosis. This case report highlights the importance of considering inguinal endometriosis in the workup of an inguinal mass and demonstrates a step-by-step surgical approach to management, with an accompanying video.

Case Report: We encountered a case of a 31-year-old nulligravid woman who presented with a painful right inguinal mass. The patient underwent diagnostic laparoscopy, which was notable for Stage 1 intra-pelvic endometriosis, without involvement of the internal inguinal ring or round ligament. The inguinal mass was carefully resected from nearby vessels, muscles, and nerves. Pathology confirmed endometriosis.

Conclusion: Gynecologists, in collaboration with a multidisciplinary team, should be prepared to workup, diagnose, and surgically manage inguinal endometriosis. When this condition is suspected, imaging should be obtained, and tissue biopsy may be considered, provided that a hernia has been ruled out. Surgical management is typically recommended and should entail diagnostic laparoscopy and excisional surgery.

Keywords: Extra-pelvic endometriosis, Inguinal endometrioma, Inguinal mass

SUPPORTING INFORMATION


Author Contributions

Gabriela Beroukhim - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Ecem Esencan - Acquisition of data, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Padmini Manrai - Acquisition of data, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Masoud Azodi - Conception of the work, Design of the work, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Yonghee K Cho - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Guarantor of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2023 Gabriela Beroukhim et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.