One of the rare reason of abdominal pain:  abdominal wall endometriosis

Objective: Endometriosis is defined as the presence of normal endometrial mucosa abnormally implanted in locations other than the uterine cavity. It is most commonly located in the pelvis but it is also rarely observed in the gastrointestinal tract, lung, liver, kidneys, central nervous system and abdominal wall. Abdominal wall endometriosis (AWE) commonly occurs following a caesarean section or pelvic surgery. The patients consult the physician mostly with complaints of cyclic abdominal pain and a palpable mass in the abdomen. The basic methods in diagnosing AWE are anamnesis and physical examination but ultrasound, computerized tomography, and sometimes magnetic resonance imaging of the abdomen are also used. Material and Methods: In our study, we retrospectively analyzed 9 patients who underwent surgery at Avcılar State Hospital General Surgery Service between January 2015 and December 2018 with a preliminary diagnosis of AWE and confirmation through pathology results. Results: Median age of the patients was 32 ± 4.66 and median body mass index (BMI) was 24.6 ± 1.15. Every patient except 1 had a history of cesarean section history. One patient was operated because of recurrence. Patients consulted the hospital with complaints of pain during menstruation and abdominal swelling. The start of the complaints was 4.1 years following C-section. Mostly ultrasound was used for imaging. For treatment, they all received en-bloc mass excision and their pathological diagnosis were compliant with endometriosis. Average surgery time was 40 minutes and average endometriosis lesion dimension was 3.4 cm. It was observed that the lesion extended to the anterior abdominal fascia in 6 of the patients, and 2 patients underwent fascia repair with propylene mesh because of the excessive defect size. No postoperative complication occured in any patient and no recurrence is observed. Conclusion: In patients with periodic abdominal pain and swelling on the abdominal wall, AWE could be suspected and early diagnosis can be realized by carefully taking medical history and following physical examination, and appropriate radiological examinations and necessary surgical intervention can be performed. The method of diagnosis and treatment is to remove the lesion through wide excision.

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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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Cеsarean section scar endometrosis

Medicinski pregled ◽

10.2298/mpns18s1083m ◽

2018 ◽

Vol 71 (suppl. 1) ◽

pp. 83-86

Author(s):

Goran Malenkovic ◽

Sanja Tomic ◽

Bratislav Stoiljkovic

Keyword(s):

Cesarean Section ◽

Abdominal Wall ◽

Metastatic Cancer ◽

Surgical Techniques ◽

Uterine Cavity ◽

Endometrial Tissue ◽

Abdominal Wall Endometriosis ◽

Primary Surgery ◽

History Of ◽

Subcutaneous Tissues

Endometriosis is defined as a functional endometrial tissue outside the uterine cavity. The ectopic endometrial tissue has been identified after gynecologic laparoscopy or laparotomy procedures in the skin, subcutaneous tissues, abdominal and pelvic wall musculature, and it represents amayor cause of acute or chronic recurrent abdominal or pelvic pain resembling the menstrual cycle. The frequency of abdominal wall endometriosis is approximately 1% of all women who had a cesarean delivery. A 39-year-old patient with a history of one prior Cesarean section, presented with continuous cyclical focal pain at the left part of cesarean scar site for the past 16 months, 23 months after Cesarean section. The patient underwent a mini laparotomy, when endometrioma was completely removed surgically. The PH diagnosis of endometriosis was based on the presence of all elements of the endometrial mucosa (glands, stroma and signs of fresh and old hemorrhage) in an inadequate place (anterior abdominal wall). Endometriosis is difficult to diagnose and it is often mistaken for other conditions such as a suture granuloma, incisional hernia, primary or metastatic cancer. Endometriosis can be prevented only with good surgical techniques and clinical practice as well as the proper care during primary surgery.

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Managing a Colonoscopic Perforation in a Patient with No Abdominal Wall

Case Reports in Surgery ◽

10.1155/2018/7175381 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Jayan George ◽

Michael Peirson ◽

Samuel Birks ◽

Paul Skinner

Keyword(s):

Abdominal Pain ◽

Incisional Hernia ◽

Plastic Surgery ◽

Abdominal Wall ◽

Abdominal Wall Defect ◽

Colonic Perforation ◽

Conservative Approach ◽

Wall Defect ◽

Surgical History ◽

History Of

We describe the case of a 37-year-old gentleman with Crohn’s disease and a complex surgical history including a giant incisional hernia with no abdominal wall. He presented on a Sunday to the general surgical on-call with a four-day history of generalised abdominal pain, nausea, and decreased stoma output following colonoscopy. After CT imaging, he was diagnosed with a large colonic perforation. Initially, he was worked up for theatre but following early senior input, a conservative approach with antibiotics was adopted. The patient improved significantly and is currently awaiting plastic surgery input for the management of his abdominal wall defect.

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Amyand's hernia and acute appendicitis: Case presentation in Basic Hospital of Chone

International Journal of Health Sciences ◽

10.29332/ijhs.v4n2.440 ◽

2020 ◽

Vol 4 (2) ◽

pp. 19-23

Author(s):

Orelvis Rodríguez Palmero ◽

Liseidy Ordaz Marin ◽

María Del Rosario Herrera Velázquez ◽

Agustín Marcos García Andrade

Keyword(s):

Abdominal Pain ◽

Inguinal Hernia ◽

Acute Appendicitis ◽

Physical Examination ◽

Iliac Fossa ◽

Amyand’S Hernia ◽

Case Presentation ◽

The North ◽

History Of ◽

The Right

Present the case of a 66-year-old male patient, with a history of right inguinal hernia, who was referred to the emergency room at the IESS de Chone Basic Hospital in the north of the Manabí province, Ecuador, with symptoms of Abdominal pain of more than 24 hours of evolution located in the right iliac fossa and inguinal region on the same side, in the physical examination the hernia was impossible to reduce, so he was taken to the operating room, in the intervention the cecal appendix was found swollen within the hernial sac, a condition known as Amyand's hernia.

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Multiple Cartilaginous Exostoses In A Pediatric Dog

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.92640 ◽

2019 ◽

Vol 47 ◽

Author(s):

José Artur Brilhante Bezerra ◽

Ramon Tadeu Galvão Alves Rodrgues ◽

Isabelle De Oliveira Lima ◽

Luanda Pâmela César De Oliveira ◽

Carlos Eduardo Bezerra De Moura ◽

...

Keyword(s):

Physical Examination ◽

Neurological Dysfunction ◽

Lateral Part ◽

Histopathological Analysis ◽

Neoplastic Disease ◽

Nerve Roots ◽

Palpable Mass ◽

Histopathological Findings ◽

Adjacent Structures ◽

History Of

Background: Multiple cartilaginous exostosis (MCE) is a rare neoplastic disease in dogs that is characterized by the presence of osteochondromas in multiple bones. MCE is a disorder of development during growth and maturation, the real etiology of which has yet to be elucidated, but is believed to have a genetic basis. Usually affected animals have a history of a palpable mass on the bone surface, causing anatomical deformities and compression of adjacent structures. Since MCE is a rare neoplastic disease in dogs it may be difficult to recognize in the clinic. The aim of this study was to report a case of MCE in a pediatric dog.Case: A female 4-month-old Rottweiler dog with a history of bone neoformation on the left hind limb, anorexia, weight loss, and difficulty walking received clinical care. The disease had its initial onset 2 months prior. At physical examination, the animal showed paresis of the hind limbs and a bony tumor on the lateral part of the left tibia. A complete blood cell count and serum biochemical profile were obtained. The only abnormality diagnosed was hyperproteinemia due to hyperglobulinemia. Other diagnostic tests were not authorized and the animal was euthanized. At the necropsy, an intrathoracic neoformation was observed from the sixth to the eighth rib on the right antimer. Some tumors were also observed on the fourth lumbar vertebra and between the first and the second sacral vertebra, and a left tibial tumor, which had been observed at physical examination. The sagittal section of the spine revealed the presence of extradural compression of the spinal cord due to vertebral proliferations with compression of the nerve roots. All of the proliferations had macroscopic similarities, being firm, sessile, irregular, and with complete adherence to deep planes. Tumor samples were submitted to histopathological analysis and the tissue morphology was compatible with osteochondroma. Based on the clinical, necroscopical, and histopathological findings, a diagnosis of MCE was established.Discussion: In MCE, animals less than one year of age are the most frequently affected, as was observed in the case reported. Clinical signs in MCE usually result from poor bone and cartilaginous anatomical formations and from compression of adjacent tissue structures. In the described patient, the proliferations located in the vertebrae and tibia and the consequent compression of nerve roots and nerves caused the neurological deficits. Unlike in canines, the etiology of MCE in humans is already well established and it is classified as an autosomal dominant genetic disorder. The diagnosis is usually obtained through the association of clinical examination with radiographic and histopathological findings. However, in the animal studied, since it was not possible to perform radiographs, confirmation was obtained only after performing histopathological examination of the neoformations, which is considered the standard for the diagnosis of MCE. Although it corresponds to a benign neoplastic process affecting dogs during their growth stage, it may significantly decrease the animal’s quality of life. In this situation, the prognosis of MCE is considered to be reserved to bad, and animals are often referred for euthanasia, as occurred in the animal under discussion, due to the progression of neurological dysfunction. Early recognition of MCE in routine pet hospital practice is of fundamental importance in order to properly institute treatment and monitoring.

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

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v29i1.30436 ◽

2016 ◽

Vol 29 (1) ◽

pp. 3-8

Author(s):

Quorrata Eynul Forhad ◽

Ali Akbar Biswas ◽

Sk Monirul Islam ◽

Md Shah Alam

Keyword(s):

Cesarean Section ◽

Abdominal Wall ◽

Power Doppler ◽

Clinical Findings ◽

Imaging Features ◽

Palpable Mass ◽

Scar Endometriosis ◽

Abdominal Wall Endometriosis ◽

Cystic Changes ◽

Pathological Material

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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Scar Endometriosis in a Patient With Bladder Exstrophy

International Surgery ◽

10.9738/intsurg-d-12-00011.1 ◽

2013 ◽

Vol 98 (2) ◽

pp. 145-148 ◽

Cited By ~ 1

Author(s):

Takahito Kitajima ◽

Mikihiro Inoue ◽

Keiichi Uchida ◽

Kohei Otake ◽

Masato Kusunoki

Keyword(s):

Abdominal Wall ◽

Bladder Exstrophy ◽

Uterine Cavity ◽

Excisional Biopsy ◽

High Signal ◽

Resonance Imaging ◽

Scar Endometriosis ◽

Abdominal Magnetic Resonance Imaging ◽

History Of ◽

Lower Abdominal Wall

Abstract Endometriosis is an ectopic occurrence of tissue morphologically and functionally resembling endometrial tissue in regions outside the uterine cavity. Although scar endometriosis after surgery has been shown to be most common among all the extrapelvic forms of endometriosis, endometriosis after bladder exstrophy surgery has not been reported, and here we present the first known case. A 26-year-old woman with a history of bladder exstrophy was aware of a painful induration at the operative scar located in the left lower abdominal wall, and presented at our hospital. Although the symptoms resolved, recurring exacerbation was observed after 9 months. Abdominal magnetic resonance imaging showed a heterogeneous mass 16 mm in diameter in the left abdominal wall with high signal intensity on T1W1 and T2W1 images. She underwent excisional biopsy of the lesion under general anesthesia. Histopathology confirmed the diagnosis of endometriosis. Eighteen months after surgery, she was well and free from recurrence.

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Clear Cell Carcinoma Arising from Abdominal Wall Endometriosis – A Report on Two Cases and Literature Review

10.21203/rs.3.rs-1101512/v1 ◽

2021 ◽

Author(s):

Vishal Bahall ◽

Lance De Barry ◽

Arlene Rampersad

Keyword(s):

Cell Carcinoma ◽

Abdominal Wall ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Case Presentation ◽

Abdominal Wall Endometriosis ◽

Aggressive Cancer ◽

History Of ◽

High Index Of Suspicion ◽

Wall Mass

Abstract Background: Malignant transformation of abdominal wall endometriosis is extremely rare. Clear cell carcinoma and endometrioid carcinoma are the two most prevalent histological subtypes of malignant endometriosis. To date, approximately thirty cases of clear cell carcinoma arising from abdominal wall endometriosis have been described worldwide.Case Presentation: We report two cases of clear cell carcinoma developing postoperatively in the anterior abdominal wall in women with a history of extensive endometriosis. Histopathology of the resected abdominal wall tumor demonstrated benign endometriosis contiguous with features of clear cell carcinoma. These histological features satisfied Sampson’s criteria which are required for diagnosing malignant endometriosis. Both patients were successfully managed with platinum-based adjuvant chemotherapy following cytoreductive surgery. Conclusion: Clear cell carcinoma arising from abdominal wall endometriosis is a rare, highly aggressive cancer with a propensity to recur or metastasize. Due to the limited publications on this clinical entity, there are no clearly established protocols regarding adjuvant treatment, and an evaluation of prognostic factors is lacking. Clinicians must have a high index of suspicion for malignant endometriosis of the abdominal wall, particularly in patients with an abdominal wall mass, prior abdominal surgery, and long-standing endometriosis. By presenting our case, we expect to raise awareness and study of this rare endometriosis-related neoplasm.

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Association of Risk Factors of Ectopic Pregnancy

The International Journal of Frontier Sciences ◽

10.37978/tijfs.v1i2.21 ◽

2017 ◽

Vol 1 (2) ◽

pp. 26-32

Author(s):

Dur e Shehwar ◽

Lubna Zubair

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Low Socioeconomic Status ◽

Uterine Cavity ◽

Pelvic Surgery ◽

Contraceptive Device ◽

Assisted Reproductive Technique ◽

History Of ◽

Tubal Disease ◽

Reproductive Technique

Abstract:Background: Ectopic pregnancy is the implantation of a fertilized ovum anywhere outside the uterine cavity. Around 95% of ectopic pregnancies occur in the Fallopian tubes. Most of these are occurring in the ampulla region. Other sites include the interstitial or the corneal region of the myometrium, cervix, ovary, peritoneal cavity (abdominal pregnancy) and in caesarean section scars. The objective of this study was to see the association of different risk factors of ectopic pregnancy.Methodology: It was a case-control study. The data was collected from Obstetrics & Gynaecology department Jinnah Hospital, Lahore and the study was completed at Gulab Devi PGMI, Lahore. For the analysis of data, SPSS version 16.00 was used.Results: 180 pregnant females were taken in which 90 were cases and 90 were controls. 16 females were more than 35 years in age of which 16% females had ectopic pregnancy. There were 3 females had history of smoking in which 3% females had ectopic pregnancy. There were 82 females who had history of pelvic surgery in which 43% female had ectopic pregnancy. There were 17 females have had history of previous ectopic pregnancy of which 14% were having ectopic pregnancy. There were 6 females have had history of IUCD (Intra uterine contraceptive device) of which 6% females were having ectopic pregnancy. There were 23 females who had history of PID (Pelvic inflammatory disease) of which 26% females were having ectopic pregnancy. There were 2 females have had history of tubal disease and had ectopic pregnancy. There were 21 females who had history of ART (Assisted reproductive technique) in which 3% females were presented with ectopic pregnancy. There was 1 female who had history of endometriosis in which 2% females were presented with ectopic pregnancy.There were 16 females have had history of low socioeconomic status of which 9% females were presented with ectopic pregnancy. There was 1 female who had history of tuberculosis and having ectopic pregnancy.Conclusion: In the present study age more than 35 years, smoking, previous ectopic pregnancy, insertion of IUCD, PID, assisted reproductive technique, tubal disease, history of pelvic surgery, endometriosis and tuberculosis had a great association with ectopic pregnancy.

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Pediatric Ileocolica Invagination: A Case Report

Britain International of Exact Sciences (BIoEx) Journal ◽

10.33258/bioex.v2i3.299 ◽

2020 ◽

Vol 2 (3) ◽

pp. 615-619

Author(s):

Sulaiman Yusuf ◽

Tita Menawati Liansyah

Keyword(s):

Abdominal Pain ◽

Intestinal Ischemia ◽

Abdominal Ultrasound ◽

Stool Examination ◽

Coffee Bean ◽

Palpable Mass ◽

Common Cause ◽

Intestinal Segments ◽

History Of ◽

In Infants And Children

Invagination or intussusception is an inversion of intestinal segments into other intestinal segments which is the most common cause of intestinal obstruction in infants and children. Early diagnosis and therapy can cause intestinal ischemia, perforation, and peritonitis which can be fatal. Trias classic symptoms consist of abdominal pain, vomiting, and blood in the stool. Invagination often occurs in children under 2 years old, with the highest incidence in children aged 4 - 9 months. The most common cause of invagination is idiopathic. Reportedly a boy, 10 months with a history of mucus with blood, vomiting, flatulence, history of colds cough. Physical examination reveals that the child is aware and active. The abdomen appears distended, palpable mass such as sausages, and intestinal hyperperistaltic. In the rectal toucher, there is mucus and blood on the handscoon. Investigations found anemia and leukocytosis. Stool examination showed blood, erythrocytes 4-6 LPB and leukocytes 8-10 LPB. Radiological examination of the abdomen appears to dilate the intestine (colon) with a coffee bean sign, the impression is in accordance with the picture of invagination. Abdominal ultrasound impression according to the picture of invagination (colo-colica). The patient was diagnosed as ileocolica intussusception and acute diarrhea without dehydration.

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