PRESENTATION OF ENDOMETRIOSIS TO GENERAL SURGEONS - A 10-YEAR EXPERIENCE

The presentation and management of 24 patients with endometriosis (med ian age 34 (range 21-68) years) presenting to general surgeons over a period of 10 years (1985-1994) was reviewed. Patients presented with a n abdominal wall swelling related to a previous Pfannenstiel incision (seven patients), umbilical swelling (four), inguinal canal swelling ( two), incidentally following appendicectomy (five), terminal ileal obs truction (two), rectal bleeding (two) and urinary symptoms (two). Endo metriosis was not suspected in most patients but was confirmed by surg ical excision or resection with minimal morbidity. No recurrence occur red during a median follow-up of 53 (range 9-113) months, Endometriosi s is a disease rarely seen by general surgeons and is often diagnosed incidentally or on histological examination. Cyclical symptoms associa ted with menstruation are present in 50 per cent of patients and shoul d suggest the diagnosis in those presenting with scar-related and/or s ubcutaneous swellings, Simple excision or resection of the presenting lesion provides adequate treatment but, since pelvic endometriosis may be present, referral to a gynaecologist is recommended in every case.