Endometriosis and myoma concurrently arising after laparoscopic subtotal hysterectomy

Young Ah Kim
In: Korean Journal of Obstetrics and Gynecology · 2010 · vol. 53(12) , pp. 1136 · doi:10.5468/kjog.2010.53.12.1136 · W2106269094
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A case report describes concurrent pelvic endometriosis and leiomyoma developing two years after laparoscopic subtotal hysterectomy, highlighting the risk of tissue implantation during uterine morcellation.

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This case report describes a 43-year-old woman who developed concurrent pelvic endometriosis and leiomyomas two years after undergoing laparoscopic subtotal hysterectomy. The patient presented with a palpable mass and pelvic pain, leading to surgical findings of endometriotic implants in the cul-de-sac and rectum alongside leiomyomas on the abdominal wall and colon. The authors attribute these conditions to the implantation of viable tissue during uterine morcellation and recommend vigorous irrigation and meticulous inspection to prevent such complications. This paper is centrally about endometriosis — specifically iatrogenic endometriosis arising as a rare complication following laparoscopic subtotal hysterectomy.

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Abstract

Iatrogenic endometriosis and leiomyoma are rare complication of laparoscopic subtotal hysterectomy. I experienced a case of pelvic endometriosis and leiomyoma concurrently arising after laparoscopic subtotal hysterectomy 2 years ago. The patient was a 43-year-old woman, and her chief complaint was palpable mass with pelvic pain in pelvis. Contrast-enhanced computed tomography image showed multiple well enhanced masses. She underwent laparoscopic surgery which revealed pelvic endometriosis and leiomyomas. The solid masses in cul-de-sac and on the surface of rectum were revealed endometriosis. The solid masses on the surface of anterior abdominal wall and descending colon were revealed leiomyoma. Implantation of viable endometrial and leiomyoma tissues could occur during uterine morcellation at time of laparoscopic subtotal hysterectomy in some patients. Vigorous irrigation and meticulous inspection should be performed.
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| Endometriosis and myoma concurrently arising after laparoscopic subtotal hysterectomy. | | Young Ah Kim | | Department of Obstetrics and Gynecology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea. [email protected] | | | | Abstract | | Iatrogenic endometriosis and leiomyoma are rare complication of laparoscopic subtotal hysterectomy. I experienced a case of pelvic endometriosis and leiomyoma concurrently arising after laparoscopic subtotal hysterectomy 2 years ago. The patient was a 43-year-old woman, and her chief complaint was palpable mass with pelvic pain in pelvis. Contrast-enhanced computed tomography image showed multiple well enhanced masses. She underwent laparoscopic surgery which revealed pelvic endometriosis and leiomyomas. The solid masses in cul-de-sac and on the surface of rectum were revealed endometriosis. The solid masses on the surface of anterior abdominal wall and descending colon were revealed leiomyoma. Implantation of viable endometrial and leiomyoma tissues could occur during uterine morcellation at time of laparoscopic subtotal hysterectomy in some patients. Vigorous irrigation and meticulous inspection should be performed. | | Keywords: Pelvic endometriosis; Leiomyoma; Laparoscopic subtotal hysterectomy; Electric morcellator | |

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