A 45-year-old female with previous history of high blood pressure, two cesarean and a laparoscopic hysterectomy with colposacropexy. She suffers from recurrent abdominal pain, a CT Scan showed a mass next to the cecum without pathological lymph nodes, study was completed with a colonoscopy that excluded lesions arising from the mucosa.
Under the suspicion of a colonic GIST an exploratory laparoscopy was performed. The patient was in supine position, a total of three trocars were used (two of 12 mm located at the umbilicus and epigastrium, another of 5mm in suprapubic position).
Revision of the abdominal cavity revealed two nodes at the parietal peritoneum close to the cecum, they measured between 1 and 3 cm. The cecum is mobilized and examined, palpation by laparoscopic instruments does not reveal any mass.
The strategy was to resect the nodes with the help of the ligasure taking care of macroscopic free margins, the samples were extracted and sent for pathological examination that was compatible with endometriosis nodes, second revision was made and revealed and extra node at the pelvis, full resection was completed.
No other lesions were found after careful examination of the abdomen, focusing in the vaginal stump, ovaries and fallopian tubes.
There was no complications, the patient started oral intake 6 hours after surgery and left the hospital the following day.