Abdominal Wall Endometriosis: Clinical Presentation And Imaging Features with Emphasis on Sonography

Objective(s): The purpose of our study was to evaluate clinical findings and sonographic features of abdominal wall endometriosis and also to report its CT and MRI appearance.Materials and methods: A retrospective study was performed from January 2008 - December 2012, yielding 12 surgically proven cases of abdominal wall endometriosis. All patients had undergone sonography including power Doppler examination. Additional CT was performed in one case and MRI in four. Pathological material was preoperatively obtained by sonographically guided puncture in six patients. The clinical data were analyzed and the imaging studies were reviewed by radiologist working in consensus.Results: All patients had a history of at least one prior cesarean section. All patients C/S was done in this institution and 1500 C/S were performed within a period of 5 years giving a frequency of 0.8% scar endometriosis after C/S. All presented with focal pain near the surgical scar, which was cyclic in three patients. Nine patients presented with a palpable mass near the scar. Sonography detected 11 lesions within the abdominal wall with a mean diameter 25mm and in one case sonography could not identify any lesion. All lesions were hypoechoic, vascular, and solid, with some cystic changes in one. MRI CT scan showed enhancement of the lesions. Finally histopathologically all were proved as endometriosis.Conclusion: Abdominal wall endometriosis frequently presents with noncyclic symptoms. Imaging findings of a solid mass near a cesarean section scar strongly suggest its diagnosis.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 3-8

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Abdominal wall endometriosis: clinical presentation, imaging features and management of five cases

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh191013021m ◽

2020 ◽

Vol 148 (7-8) ◽

pp. 484-488

Author(s):

Goran Malenkovic ◽

Sanja Tomic ◽

Jasmina Boban ◽

Nensi Lalic ◽

Marko Bojovic

Keyword(s):

Cesarean Section ◽

Abdominal Wall ◽

Surgical Techniques ◽

Case Series ◽

Uterine Cavity ◽

Good Clinical Practice ◽

Definitive Treatment ◽

Imaging Features ◽

Abdominal Wall Endometriosis ◽

Uncommon Condition

Introduction. Endometriosis represents a functional endometrium outside the uterine cavity. Ectopic endometrial tissue has been identified within the pelvis, affecting both pelvic and extrapelvic organs, causing recurrent pelvic or abdominal pain corresponding to the menstrual cycle. The incidence of abdominal wall endometriosis after Cesarean section is approximately 2%. It is often mistaken for other conditions primarily because this condition is underestimated on imaging. The objective of this case series is to summarize possible clinical and radiological presentations of this uncommon condition. Outline of cases. The authors present a case series of five patients who developed abdominal wall endometriosis after Cesarean section. Having been diagnosed clinically, the patients underwent open abdominal surgery, and were treated by surgical resection. Conclusion. Good clinical practice and excellent surgical techniques may help in preventing endometriosis, while adequate clinical examination and proper imaging can help in presurgical planning and successful definitive treatment.

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Cesarean scar endometriosis: our recent experiences

10.33699/pis.2021.100.1.27-31 ◽

2021 ◽

Vol 100 (1) ◽

Keyword(s):

Abdominal Pain ◽

Abdominal Wall ◽

Uterine Cavity ◽

Lower Abdominal Pain ◽

Definitive Treatment ◽

Palpable Mass ◽

Scar Endometriosis ◽

Cesarean Scar ◽

Abdominal Wall Endometriosis ◽

Complete Surgical Excision

Introduction: Endometriosis is defined as the presence of endometrial tissue, endometrial glands or endometrial stroma outside the uterine cavity causing chronic inflammatory response. The prevalence of abdominal wall endometriosis is less than 1%. Cesarean scar endometriosis is the most common type of abdominal wall endometriosis. Chronic lower abdominal pain amplified during menstruation and palpable mass in the area of scar are the main symptoms. Generally, surgical resection with negative resection margins offers the best chance for definitive treatment of abdominal wall endometriosis. Case report: The authors present two female patients in fertile age with chronic pain in the area of Cesarean scar. The preoperatively assumed endometriosis was histologically confirmed after complete surgical excision. Conclusion: Abdominal wall endometriosis is rare. However, it is a possible cause of constant lower abdominal pain, impacting quality of life of the patient.

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Evaluation of Cases of Abdominal Wall Endometriosis at Universidade Estadual de Campinas in a period of 10 Years

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0037-1603965 ◽

2017 ◽

Vol 39 (08) ◽

pp. 403-407 ◽

Cited By ~ 5

Author(s):

Daniela Yela ◽

Lucas Trigo ◽

Cristina Benetti-Pinto

Keyword(s):

Cesarean Section ◽

Abdominal Wall ◽

Recurrence Rate ◽

Clinical Manifestations ◽

Disease Recurrence ◽

Surgical Margins ◽

Abdominal Wall Endometriosis ◽

Postoperative Control ◽

Epidemiological Characteristics ◽

Previous Cesarean

Purpose To determine the clinical and epidemiological characteristics of abdominal wall endometriosis (AWE), as well as the rate and recurrence factors for the disease. Methods A retrospective study of 52 women with AWE was performed at Universidade Estadual de Campinas from 2004 to 2014. Of the 231 surgeries performed for the diagnosis of endometriosis, 52 women were found to have abdominal wall endometriosis (AWE). The frequencies, means and standard deviations of the clinical characteristics of these women were calculated, as well as the recurrence rate of AWE. To determine the risk factors for disease recurrence, Fisher's exact test was used. Results The mean age of the patients was 30.71 ± 5.91 years. The main clinical manifestations were pain (98%) and sensation of a mass (36.5%). We observed that 94% of these women had undergone at least 1 cesarean section, and 73% had used medication for the postoperative control of endometriosis. The lesion was most commonly located in the cesarean section scar (65%). The recurrence rate of the disease was of 26.9%. All 14 women who had relapsed had surgical margins compromised in the previous surgery. There was no correlation between recurrent AWE and a previous cesarean section (p = 0.18), previous laparotomy (p = 0.11), previous laparoscopy (p = 0.12) and postoperative hormone therapy (p = 0.51). Conclusion Women with previous cesarean sections with local pain or lumps should be investigated for AWE. The recurrence of AWE is high, especially when the first surgery is not appropriate and leaves compromised surgical margins.

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Abdominal wall endometriosis: comparative imaging on power Doppler ultrasound and MRI

Clinical Radiology Extra ◽

10.1016/j.cradex.2004.02.004 ◽

2004 ◽

Vol 59 (8) ◽

pp. 74-77 ◽

Cited By ~ 4

Author(s):

J Teh ◽

J Leung ◽

S Dhar ◽

N.A Athanasou

Keyword(s):

Abdominal Wall ◽

Doppler Ultrasound ◽

Power Doppler ◽

Power Doppler Ultrasound ◽

Abdominal Wall Endometriosis

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Endometriosis of Rectus Muscle Excised During Cesarean Section: A Case Report and Literature Review

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2016.489 ◽

2016 ◽

Author(s):

Recep Erin ◽

Kübra Baki Erin ◽

Derya Burkankulu Ağırbaş ◽

Burcu Kemal Okatan

Keyword(s):

Case Report ◽

Pregnant Woman ◽

Literature Review ◽

Cesarean Section ◽

Abdominal Wall ◽

Rectus Muscle ◽

Surgical Excision ◽

Treatment Method ◽

Abdominal Wall Endometriosis ◽

Subcutaneous Mass

We aimed to present a case with abdominal wall endometriosis following cesarean section in this case report. A 32 year old 39 weeks pregnant woman with G2P1 was admitted to gynaecology clinic with abdominal lump and pain in the midline. Her physical examination included a hard and painful palpable subcutaneous mass of 4x5 cm size in the midline of the abdomen which was semisolid and irreducible. Under general anesthesia, the mass on the rectus muscle was excised with the healthy tissue around with the diagnosis of endometriosis during cesarean section and the pathological diagnosis was reported as endometriosis. Surgical excision is the best treatment method in abdominal wall endometriosis.

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Abdominal wall endometriosis: experience of the General Surgery Service of the Antônio Pedro University Hospital of the Universidade Federal Fluminense

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-6991e-20202544 ◽

2020 ◽

Vol 47 ◽

Author(s):

JORGE EDUARDO FARIA ROCHA COSTA ◽

ITALO ACCETTA ◽

FRANCISCO JOSÉ SANTOS MAIA ◽

RENATO AUGUSTO MOREIRA DE SÁ

Keyword(s):

Cesarean Section ◽

Abdominal Surgery ◽

Abdominal Wall ◽

General Surgery ◽

Previous History ◽

Reproductive Age ◽

University Hospital ◽

Significance Level ◽

Abdominal Wall Endometriosis ◽

Previous Cesarean

ABSTRACT Objective: to study the characteristics of women undergoing abdominal surgery with suspected abdominal wall endometriosis or abdominal wall tumor, and to assess the association with age, race and previous cesarean delivery. Method: retrospective and analytical study carried out from January 2000 to December 2019, at the General Surgery Service of Hospital Universitário Antônio Pedro (HUAP) at Universidade Federal Fluminense (UFF). Medical records of 100 patients with abdominal wall endometriosis and other types of abdominal wall tumors were analyzed. Age, color, previous history of cesarean section or abdominal surgery and histopathological data were verified. The patients were classified as young adults (aged between 18 and 28 years and 11 months) and adults. The SPSS program was used for data analysis, Fisher’s test with a significance level of 0.05. Results: abdominal wall endometriosis with histopathological confirmation was found in 22%, the mean age was 52.28 ± 18.66 which was lower when compared to other diagnoses. There was an association between previous cesarean section and abdominal wall endometriosis (p <0.005). Conclusion: the women with a diagnosis of abdominal wall endometriosis had undergone previous cesareans (the majority) and were in an active reproductive age. Although the brown skin women were the most frequent, there was no statistical difference.

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Atypical Endometrial Hyperplasia Arising in a Cesarean Section Scar: A Mechanism of Malignant Transformation

Case Reports in Oncology ◽

10.1159/000499760 ◽

2019 ◽

Vol 12 (1) ◽

pp. 317-321

Author(s):

Marta Monist ◽

Dorota Lewkowicz ◽

Maciej Jóźwik ◽

Marek Gogacz ◽

Michał Bogusiewicz ◽

...

Keyword(s):

Cesarean Section ◽

Malignant Transformation ◽

Endometrial Hyperplasia ◽

Morbidly Obese ◽

Cesarean Sections ◽

Recurrent Pain ◽

Palpable Mass ◽

Scar Endometriosis ◽

Abdominal Scar ◽

Atypical Endometrial Hyperplasia

The incidence of scar endometriosis in Cesarean sections varies between 0.03 and 0.4%. However, the recently increased rate of Cesarean sections worldwide may be causing an increase in occurrence of scar endometriosis. This report presents anatomopathological evidence of an early-stage malignant transformation in endometriotic tissue from a post-Cesarean scar and briefly reviews possible underlying mechanisms. A 40-year-old woman with a body mass index of 42.7 was referred to the gynecological department with recurrent pain and presence of a palpable mass in her Cesarean section scar. She had undergone this procedure 7 years earlier and began experiencing discomfort and pain at the incision site 6 months postoperatively. Surgical treatment was instituted with complete removal of the lesion. Anatomopathological examination revealed endometriotic tissue intertwined with atypical endometrial hyperplasia and fibrosis. At 2 years’ follow-up, she was asymptomatic, both clinically and based on ultrasound examination. Endometriotic foci inoculated within an abdominal scar may undergo malignant transformation. Long-lasting abdominal scar endometriosis, in morbidly obese women, requires special attention from the physician.

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