Primary Umbilical Endometriosis with Concurrent Paraumbilical Hernia:A Case Report

Background: Umbilical endometriosis is a rare form of extra pelvic endometriosis accounting for less than 1% of all endometriosis cases. It commonly presents with cyclical pain, swelling and bleeding from the umbilicus, often leading to delayed diagnosis because of its resemblance to other umbilical pathologies. This report describes a rare case of primary umbilical endometriosis with concurrent paraumbilical hernia, highlighting diagnostic challenges and management considerations. Case Presentation: A 27-year-old multiparous woman presented with a 6-month history of cyclical umbilical bleeding and severe pain associated with menstruation. Physical examination revealed a firm, tender, dark-brown umbilical nodule measuring approximately 2 × 2 cm. Ultrasonography demonstrated a mixed echogenic lesion in the umbilical region suggestive of endometriosis. Laboratory investigations, including serum CA-125, were within normal limits. Based on the clinical and radiological findings, a diagnosis of primary umbilical endometriosis with concurrent paraumbilical hernia was made. The patient was planned for surgical excision with hernioplasty followed by histopathological evaluation. Conclusion: Primary umbilical endometriosis should be considered in reproductive aged women presenting with cyclical umbilical symptoms, particularly bleeding and pain associated with menstruation. Early clinical suspicion and surgical management are essential for definitive diagnosis and prevention of recurrence. Chatt Maa Shi Hosp Med Coll J; Vol.25 (2); July 2026; Page 116-119