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Case


A 45-year-old female with previous history of high blood pressure, two cesarean and a laparoscopic hysterectomy with colposacropexy. She suffers from recurrent abdominal pain, a CT Scan showed a mass next to the cecum without pathological lymph nodes, study was completed with a colonoscopy that excluded lesions arising from the mucosa.


Treatment


Under the suspicion of a colonic GIST an exploratory laparoscopy was performed. The patient was in supine position, a total of three trocars were used (two of 12 mm located at the umbilicus and epigastrium, another of 5mm in suprapubic position).

Revision of the abdominal cavity revealed two nodes at the parietal peritoneum close to the cecum, they measured between 1 and 3 cm. The cecum is mobilized and examined, palpation by laparoscopic instruments does not reveal any mass.

The strategy was to resect the nodes with the help of the ligasure taking care of macroscopic free margins, the samples were extracted and sent for pathological examination that was compatible with endometriosis nodes, second revision was made and revealed and extra node at the pelvis, full resection was completed.

No other lesions were found after careful examination of the abdomen, focusing in the vaginal stump, ovaries and fallopian tubes.


Outcome


There was no complications, the patient started oral intake 6 hours after surgery and left the hospital the following day.

Faculty keyboard_arrow_down
Dr. Gabriel Diaz Del Gobbo Bariatric Surgeon, Associate Program Director of the General Surgery Residence at Cleveland Clinic Abu Dhabi, United Arab Emirates General Surgery
Dr. María Fernández-Hevia General and Digestive SurgeryGeneral and Digestive Surgery in SESPA General Surgery
Dr. Antonio M. de Lacy MD, PhD, FACS (Hon), FASCRS (Hon), IQL Director, Department of Surgery, Hospital Quirón Barcelona, Hospital Ruber Internacional Madrid and Clínica Rotger Palma de Mallorca; AIS Founder and President, Spain General Surgery
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