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Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal

Umbilical endometriosis represents 30–40% of abdominal wall endometriosis and around 0.5–1.0% of all cases of endometriosis. The aim of this systematic review is to revisit the epidemiology, signs, and symptoms and to formulate a pathogenic theory based on literature data. We performed a systematic...

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Autores principales: Dridi, Dhouha, Chiaffarino, Francesca, Parazzini, Fabio, Donati, Agnese, Buggio, Laura, Brambilla, Massimiliano, Croci, Giorgio Alberto, Vercellini, Paolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8879338/
https://www.ncbi.nlm.nih.gov/pubmed/35207266
http://dx.doi.org/10.3390/jcm11040995
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author Dridi, Dhouha
Chiaffarino, Francesca
Parazzini, Fabio
Donati, Agnese
Buggio, Laura
Brambilla, Massimiliano
Croci, Giorgio Alberto
Vercellini, Paolo
author_facet Dridi, Dhouha
Chiaffarino, Francesca
Parazzini, Fabio
Donati, Agnese
Buggio, Laura
Brambilla, Massimiliano
Croci, Giorgio Alberto
Vercellini, Paolo
author_sort Dridi, Dhouha
collection PubMed
description Umbilical endometriosis represents 30–40% of abdominal wall endometriosis and around 0.5–1.0% of all cases of endometriosis. The aim of this systematic review is to revisit the epidemiology, signs, and symptoms and to formulate a pathogenic theory based on literature data. We performed a systematic literature review using the PubMed and Embase databases from 1 January 1950 to 7 February 2021, according to the PRISMA guidelines. The review was registered at PROSPERO (CRD42021239670). Studies were selected if they reported original data on umbilical endometriosis nodule defined at histopathological examination and described as the presence of endometrial glands and/or stromal cells in the connective tissue. A total of 11 studies (10 retrospective and one prospective), and 14 case series were included in the present review. Overall, 232 umbilical endometriosis cases were reported, with the number per study ranging from 1 to 96. Umbilical endometriosis was observed in 76 (20.9%; 95% CI 17.1–25.4) of the women included in studies reporting information on the total number of cases of abdominal wall endometriosis. Umbilical endometriosis was considered a primary form in 68.4% (158/231, 95% CI 62.1–74.1) of cases. A history of endometriosis and previous abdominal surgery were reported in 37.9% (25/66, 95% CI 27.2–49.9) and 31.0% (72/232, 95% CI 25.4–37.3) of cases, respectively. Pain was described in 83% of the women (137/165, 95% CI 76.6–88.0), followed by catamenial symptoms in 83.5% (142/170, 95% CI, 77.2–88.4) and bleeding in 50.9% (89/175, 95% CI 43.5–58.2). In the 148 women followed for a period ranging from three to 92.5 months, seven (4.7%, 95% CI 2.3–9.4) recurrences were observed. The results of this analysis show that umbilical endometriosis represents about 20% of all the abdominal wall endometriotic lesions and that over two thirds of cases are primary umbilical endometriosis forms. Pain and catamenial symptoms are the most common complaints that suggest the diagnosis. Primary umbilical endometriosis may originate from implantation of regurgitated endometrial cells conveyed by the clockwise peritoneal circulation up to the right hemidiaphragm and funneled toward the umbilicus by the falciform and round liver ligaments.
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spelling pubmed-88793382022-02-26 Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal Dridi, Dhouha Chiaffarino, Francesca Parazzini, Fabio Donati, Agnese Buggio, Laura Brambilla, Massimiliano Croci, Giorgio Alberto Vercellini, Paolo J Clin Med Review Umbilical endometriosis represents 30–40% of abdominal wall endometriosis and around 0.5–1.0% of all cases of endometriosis. The aim of this systematic review is to revisit the epidemiology, signs, and symptoms and to formulate a pathogenic theory based on literature data. We performed a systematic literature review using the PubMed and Embase databases from 1 January 1950 to 7 February 2021, according to the PRISMA guidelines. The review was registered at PROSPERO (CRD42021239670). Studies were selected if they reported original data on umbilical endometriosis nodule defined at histopathological examination and described as the presence of endometrial glands and/or stromal cells in the connective tissue. A total of 11 studies (10 retrospective and one prospective), and 14 case series were included in the present review. Overall, 232 umbilical endometriosis cases were reported, with the number per study ranging from 1 to 96. Umbilical endometriosis was observed in 76 (20.9%; 95% CI 17.1–25.4) of the women included in studies reporting information on the total number of cases of abdominal wall endometriosis. Umbilical endometriosis was considered a primary form in 68.4% (158/231, 95% CI 62.1–74.1) of cases. A history of endometriosis and previous abdominal surgery were reported in 37.9% (25/66, 95% CI 27.2–49.9) and 31.0% (72/232, 95% CI 25.4–37.3) of cases, respectively. Pain was described in 83% of the women (137/165, 95% CI 76.6–88.0), followed by catamenial symptoms in 83.5% (142/170, 95% CI, 77.2–88.4) and bleeding in 50.9% (89/175, 95% CI 43.5–58.2). In the 148 women followed for a period ranging from three to 92.5 months, seven (4.7%, 95% CI 2.3–9.4) recurrences were observed. The results of this analysis show that umbilical endometriosis represents about 20% of all the abdominal wall endometriotic lesions and that over two thirds of cases are primary umbilical endometriosis forms. Pain and catamenial symptoms are the most common complaints that suggest the diagnosis. Primary umbilical endometriosis may originate from implantation of regurgitated endometrial cells conveyed by the clockwise peritoneal circulation up to the right hemidiaphragm and funneled toward the umbilicus by the falciform and round liver ligaments. MDPI 2022-02-14 /pmc/articles/PMC8879338/ /pubmed/35207266 http://dx.doi.org/10.3390/jcm11040995 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Dridi, Dhouha
Chiaffarino, Francesca
Parazzini, Fabio
Donati, Agnese
Buggio, Laura
Brambilla, Massimiliano
Croci, Giorgio Alberto
Vercellini, Paolo
Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal
title Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal
title_full Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal
title_fullStr Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal
title_full_unstemmed Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal
title_short Umbilical Endometriosis: A Systematic Literature Review and Pathogenic Theory Proposal
title_sort umbilical endometriosis: a systematic literature review and pathogenic theory proposal
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8879338/
https://www.ncbi.nlm.nih.gov/pubmed/35207266
http://dx.doi.org/10.3390/jcm11040995
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