Thank you for your query at DoctorSpring.com
Before elaborating on your insightful query and offering an opinion, I have a quick question.
Prior to the appendix surgery, have you had any surgeries ?
I need to know this before i can advise you further,
Please write back.
Patient replied :
No, my appendix was my first/only surgery I have had. Also, incase I didn't include it originally and incase it matters, it was done laparoscopically. Also incase any of these are factors (since they are questions doctors always ask) I am 5'3, 150 lbs. exercise regularly, drink alcohol occasionally and I am not/haven't ever been a smoker.
Thanks for writing to us with your health concern.
I think it is clear what the condition is.
You always had endometriosis - that is, endometriotic deposits outside of the uterus.
These could involve the peritoneum, the lining of the abdomen just under the skin and muscle of the abdomen.
That would explain your discomfort and and pain over the navel, alongwith a slight hernia too, that could have been there.
Now what has happened is a distinct entity called scar endometriosis.
The laparoscopic appendix surgery was done via the umbilicus ( navel ) and the residual complication is scar endometriosis, as endometriotic tissue has now invaded the scar.
That explains the pent up blood collection that happened post operatively too, since endometriotic tissue is very vascular.
Now it has healed, but it is still endometriotic tissue, so it causes monthly cyclical pain.
The clincher is the fact that you have periodic bruising too, mostly coinciding with the monthly pain.
That is typical of endometriosis, just like the uterine tissue becomes vascular and bleeds each month, this ectopic endometriotic tissue does the same.
Treatment options ?
1. Do nothing - if the pain and bruising is bearable, the birth control keeps it under check.
2. Excise it - get that area removed, and have the diagnosis confirmed with a biopsy that will confirm that the tissue is endometriotic. Can be easily done by an experienced surgeon.
3. If pain is unbearable, take hormonal therapy for the endometriotic tissue .
4. Get an MRI done anyway, it is excellent for diagnosis of endometriosis.
Hope my answer helped you.
Feel free to discuss further.
Patient replied :
Thank you. That is an excellent and thorough answer and exactly what i was looking for as far as advice! It kind of goes along with some of my own research I have done on the matter over the last 6 months. Very helpful. My biggest worry was if the bruising was a sign of a complication. I plan to see a new doctor in March when I am due for my usual checkups and I wanted to be prepared with some possible talking points to have with the new doctor and I may request an MRI too just for peace of mind/verification purposes.
At this point being the bruising is minor and pain isnt dabilitating or anything like that I hope to just keep it managed.
I am going to close this out - thanks again - very helpful!