ABSTRACT
Background: Surgical scar endometriosis is typically presented as a slow-growing, painful abdominal mass near the site of a past surgery. Endometriosis on the trocar port site is rare. To best of our knowledge, only 17 cases have been reported in the literature. The nonspecific nature of endometriosis presents a diagnostic challenge, and it is often considered as an incisional hernia or other conditions
Case: Here, we described our experience with a recurrent abdominal scar endometriosis case at the trocar port site of a previous laparoscopy, which was initially thought to be an incisional hernia
Conclusion: Abdominal wall endometriosis should be considered as an important differential diagnosis in females with a positive history of prior abdominal surgery, presented with painful nodule or mass at the site of the surgery
ABSTRACT
Tracheal reconstructions are aimed at rearranging or replacing parts of the tracheal tissue by different techniques. Here we introduce a new technique for tracheal reconstruction. In 10 adult dogs, after intubation with an endotracheal tube, a segment of trachea including seven tracheal rings was resected circumferentially. A submuscular tunnel was induced between mucosal and muscular layers of the adjacent esophagus lying right next to the trachea. The esophageal submuscular tunnel starts and ends exactly at the level of distal and proximal ends of tracheal resection, respectively. Inforced Gore-Tex passed through the esophageal submuscular tunnel the distal segment of trachea and end-to-end anastomosis were made between distal ends of Gore-Tex and trachea, then endotracheal tube removed and the same procedure was made for proximal ends of Gore-Tex and trachea. Afterward, the proximal and distal ends of the esophageal tunnel were approximated to proximal and distal tracheal parts over the anastomosis. All dogs, except one due to anesthetic problem, survived and tolerated the operation; the first two dogs experienced postoperative fever, aspiration pneumonia, and died due to tracheoesophageal fistula. All survived animals were eating and barking well. We started to scarify dogs at least 6 and 12 weeks after operation for microscopy and pathologic examination. The Gore-Texes were patent and supported externally with fibrous connective tissue in esophageal tunneling, with in growth of respiratory epithelium on inner surfaces. Air tightness, good re-epithelialization, and relatively no limitation of esophageal length and no risk of luminal collapse are advantages of tracheal reconstruction by submuscular esophageal tunneling. This new method is worthy of further investigation, as it is technically feasible and easy to implement