A Curious Case of Recurrent Umbilical Swelling: Case Report and Literature Review

Abstract

Background: Umbilical endometriosis, a rare benign condition, is clinically difficult to differentiate from other diseases that result in the formation of an umbilical nodule. It is caused by the presence of ectopic endometrial tissue in the umbilicus, which overtly presents as a painful, discoloured swelling in the umbilicus. However, in our case the presentation wasn't as obvious. The endometrial tissue was embedded within an umbilical hernia. Case Summary: Our patient was a 37-year-old female with a past medical/surgical history of a subtotal colectomy for ulcerative colitis in 2001 followed by an ileo-rectal anastomosis. 17 years later, she was referred to the surgical outpatient clinic from GP practice with a painful umbilical/incisional hernia surrounding the previous scar and just above the umbilicus, this pain, particularly worsening during her menstrual cycle. Multiple blood tests and ultrasound scans of her abdomen failed to diagnose a cause for her agony which mandated an elective excision of the swelling. This successfully resolved her symptoms. Conclusion: Umbilical endometriosis is a potential diagnosis in females with a painful umbilical swelling, imaging has no diagnostic role and excision is the definitive treatment.