Abdominal Endometriosis

Around 10% of endometriosis cases deviate from the pelvic cavity, affecting regions such as the intestine, genitourinary system, kidneys, lungs, and skin [1]. Aside from rectovaginal endometriosis, and colon-based instances, endometriosis can also extend to the small intestine and even the stomach. Nonetheless, endometriosis manifesting on the stomach is an exceedingly uncommon occurrence.

Symptoms of Gastric Endometriosis

Much like other presentations of endometriosis, symptoms vary significantly from person to person. Frequently, gastrointestinal endometriosis is asymptomatic, implying that noticeable symptoms may not be present. Additionally, gastrointestinal issues associated with endometriosis can emerge even in the absence of bowel involvement. However, when endometriosis affects the gastrointestinal tract, it can materialize as abdominal and pelvic pain, constipation, or even visible protrusions in the abdominal region when viewed in mirrors, among other indications [1]. In cases where the stomach is involved, discomfort in the upper abdominal area may also arise.

Diagnosis

Due to the wide range of symptoms associated with endometriosis, diagnosing gastric endometriosis is a complex endeavor. A meticulous evaluation becomes necessary when encountering a submucosal mass, situated beneath the mucosal layer within the stomach. Detecting endometriosis within the stomach involves a comprehensive examination through gastroscopy. However, external foci of endometriosis often escape detection during this procedure and are more prominently visible during laparoscopies. As a result, during laparoscopic procedures, medical professionals place special emphasis on thoroughly exploring the upper abdominal region [2].

Treatment

Based on the findings of a specific study, surgical resection has demonstrated a potential cure rate exceeding 95% among patients. Furthermore, the post-surgery recurrence rate, indicating the likelihood of the condition’s reappearance, stood at 4.3%. Nonetheless, due to the exceptional rarity of gastric endometriosis, devising an optimal treatment approach remains a challenge, and a definitive course of action cannot be precisely determined [1]. As with other variations of endometriosis, patients should engage in personalized discussions regarding treatment with medical professionals at an endometriosis center. Given that endometriosis often manifests at multiple sites concurrently, treatment planning invariably incorporates all symptomatic concerns and sites of endometrial involvement.

In cases where surgery is deemed necessary, the medical team should include a visceral surgeon specializing in stomach-related procedures.

References

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