{"paper_id":"42a4bb47-fff6-4086-82fd-fe871ea55fa4","body_text":"Importance of the Doctor Patient Communication to make an Adequate\nDiagnosis, Apropos of a Case of Endometriosis of Rare Location\nMantinan Vivanco.I1 and Maru Hermosa de la Llama2*\n1Médico de Familia, Residente de tercer año, Spain\n2Médico de Familia, Titular C.S.Puerto Chico, Santander,, Cantabria, Spain\n*Corresponding author: Maru Hermosa de la Llama, Médico de Familia, Titular C.S.Puerto Chico, Santander,, Kantabrien, Spain, Tel: 34+699071061,\nE-mail: maru.hermosa@gmail.com\nReceived date: February 29, 2016; Accepted date: May 27, 2016; Published date: May 31, 2016\nCitation: Vivanco IM, de la Llama MH (2016) Importance of the Doctor Patient Communication to make an Adequate Diagnosis, Apropos of a\nCase of Endometriosis of Rare Location. Reproductive Immunol Open Acc 1:13. doi: 10.21767/2476-1974.100013\nCopyright: © 2016 Maru Hermosa de la Llama, et al. This is an open-access article distributed under the terms of the Creative Commons\nAttribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are\ncredited.\nShort Commentary\nThe presence of focal ectopic endometrial cells (glandular and\nstromal cells) outside the uterine cavity is defined as\nendometriosis. Endometriosis is a common disease in women,\nwhose cause is not known yet. Several theories try to explain the\norigin and development of this disease, being the theory named\n“retrograde menstruation\", one of the most accepted theory.\nThis theory, proposes that part of menstrual flow would pass\nthrough the fallopian tubes to abdominal cavity, instead of\nheading into the vagina through cervix. Endometrial cells would\nestablish anywhere of abdominal cavity, giving rise to the so-\ncalled endometriotic focus. Besides of \"retrograde\nmenstruation\" occurrence, which is quite more common than\nendometriosis in itself, probably, a kind of immunological\ndisorder exist, that favouring the implantation and development\nof these foci (Figure 1) [1].\nFigure 1: Etiology of endometriosis\nEndometriosis is a very common disease, around a 15 percent\nof women in childbearing age, experiences it, those who attend\nto their primary care centre because of discomforts produced by\nthe symptoms of this condition 2. Many women are\nasymptomatic, and the most common symptoms are shown in in\ntable 1.\nTable 1: symptoms of endometriosis\nSymptoms of endometriosis %\nDepressing in 50% of the cases 50%\nSymptomatic 50%\nDysmenorrhoea 50-90%\nDyspareunia 25-40%\nHypermenorrea -\nInfertility 30-40%\nIntestinal disorders -\nAmenorrhea -\nDysfunctional bleeding -\nThe case of a 40 yearold woman, gilt, no history, surgical or\nGynaecological medical interest, that go to our inquiry by\numbilical bleeding 4 days duration and spontaneous remission.\nThe physical examination of the area is normal, no skin lesions,\nnot seen bleeding in that moment and palpable masses are\ndiscarded. It informs the patient of what was observed,\nreassuring it is and he is recommended that you return if\nsymptoms return.\nA month later, it comes back with the same symptoms. In this\nnew interview, and after a scan of the problem through a more\nthorough anamnesis, appears a relevant piece of information,\nthe coincidence of bleeding with menstruation; The physical\nexamination area shows that it is again without alterations.\nBefore this find raises the hypothesis of endometriosis and is the\nderived radiology service to perform an ultrasound.\nThe Ultrasound in our patient study showed a dermal nodule\ninfra umbilical compatible with the diagnosis of presumption\nShort Communication\niMedPub Journals\nhttp://www.imedpub.com/\nDOI: 10.21767/2476-1974.100013\nReproductive Immunology: Open Access\nISSN 2476-1974\nVol.1 No.13:13\n2016\n© Under License of Creative Commons Attribution 3.0 License | This article is available from: http://dx.doi.org/10.21767/2476-1974.100013 1\n\nwhich was confirmed definitively with the histopathological\nstudy part obtained after surgical treatment performed by the\ngynaecologist.\nThus, endometriosis can be suspected by history clinic,\nscanning and ultrasound techniques. Confirmation realized by\nhistopathological studio, still the treatment surgical and\npharmacological hormone combination of estrogen and\nprogesterone [3,4].\nReferences\n1. Botella Llusiá J, Clavero Núñez JA (1993) Tratado de ginecología.\nEnfermedades del aparato genital femenino. 14.ª ed. Madrid:\nEditorial Díaz de Santos PP 8534.\n2. Lombardia Prieto J (2007) Ginecología y Obstetricia: manual de\nconsulta rápida. 2.ª ed. Buenos Aires: Panamericana.\n3. Berek y Novak. Ginecologia (2012) 15.a ed. Filadelfia: Lipincott,\nWilliams & Wilkins PP 505.\n4. Bonilla-Musoles F, Pellicer A (2007) Obstetricia, reproducci6n y\nGinecologia basicas. l.a ed. Buenos Aires: Panamericana.\n \nReproductive Immunology: Open Access\nISSN 2476-1974 Vol.1 No.13:13\n2016\n2 This article is available from: http://dx.doi.org/10.21767/2476-1974.100013","source_license":"CC0","license_restricted":false}