{"paper_id":"7ddc820c-f78a-48ee-8b21-865e69459f78","body_text":"ECR 2012 / C-0505\nCesarean scar endometriosis: Clinical presentation and imaging features with a focus on MRI\nCongress:\nECR 2012\nPoster Number:\nC-0505\nType:\nEducational Exhibit\nKeywords:\nAbdomen, MR, CT, Diagnostic procedure, Obstetrics, Abscess, Haemorrhage\nAuthors:\nA. S. Dumitrescu, T. Herold; Berlin/DE\nDOI:\n10.1594/ecr2012/C-0505\nLearning objectives\nEndometriosis is a common and important clinical problem of women,\npredominantly those in the reproductive age group.\nEndometriosis of the abdominal wall is less frequent and is mostly associated with cesarean section scars.\nIt can pose diagnostic difficulties and should be in the differential diagnosis of abdominal wall lumps in females.\nThe purpose of this exhibit is:\n1.\nTo review the clinical presentation and imaging findings of abdominal wall endometriosis with intramuscular as well as subcutaneous lesions following caesarian section;\n2.\nTo discuss diagnostic strategies...\nBackground\nEndometriosis was first described by Rokitansky in 1860 and is defined as the presence of endometrial glandular tissue outside of the uterus.\nClinical presentation\nThe most common symptoms are dysmenorrhea,\ndyspareunia,\npelvic pain,\nand infertility,\nalthough only a minority of patients present with all the symptoms andmany patients are asymptomatic.\nLocalization\nFrequent localizations in the pelvis include the ovaries,\nuterine ligaments,\nserosal surfaces,\ncul-de-sac,\nfallopian tubes,\nrectosigmoid,\nand urinary bladder (Fig. 1).\n[3] Extrapelvic endometriosis are bladder,\nkidney,\nbowel,\nomentum,\nlymph nodes,\nlungs,\npleura,\nextremities,...\nImaging findings OR Procedure details\nImaging considerations\nEndometriosis,\nin patients with scars,\nis more common in the abdominal skin and subcutaneous tissue compared to muscle and fascia.\nEndometriosis involving only the rectus muscle and sheath is very rare.\n[7] In this unusual localization,\nclinical as well as initial imaging findings are likely to be misinterpreted by physicians and radiologists (e.g.,\nas abscesses or malignant tumors).\nAlong with the comparative rarity of the disease this leads to frequent overlooking of the correct diagnosis.\n[8,9,10]\nUsually,\nthe initial imaging examination for suspected...\nConclusion\nEndometriosis is a common and important clinical problem of women,\npredominantly those in the reproductive age group.\nThe condition is associated with islands of ectopic endometrial tissue.\nLocalization in the abdominal wall as presented above is rare and mostly associated with a cesarean section.\nSuch lesions can mimic tumors of the soft tissue or hematomas of other origin.\nIt is important to keep this rare differential diagnosis in mind and to inquire about any association of the clinical symptoms with the menstrual cycle,\nsince the...\nPersonal Information\nA.S.\nDumitrescu,\nT.\nHerold\nInstitut für Röntgendiagnostik\nHELIOS Klinikum Berlin-Buch\nSchwanebecker Chaussee 50\n13125 Berlin,\nGermany\nYou can e-mail the corresponding author at:\n[email protected]\nReferences\n1.\nOlive,\nD.L.,\nSchwartz,\nL.B.\nEndometriosis.\nN Engl J Med 1993 328: 1759-1769.\n2.\nKhetan N,\nTorkington J,\nWatkin A,\nJamison MH,\nHumphreys WV.\nEndometriosis: presentation to general surgeons.\nAnn R Coll Surg Engl 1999; 81: 255-259.\n3.\nKinkel K.,\nFrei K.A.,\nBalleyguier C.,\nChapron C.Diagnosis of endometriosis with imaging: a review.\nEur Radiol 2006;16(2):285–298.\n4.\nMarkham SM,\nCarpenter SE,\nRock JA.\nExtra pelvic endometriosis.\nObstet Gynecol Clin North Am 1989; 16:193-219.\n5.\nRoberge RJ,\nKantor WJ,\nScorza L.\nRectus abdominis endometrioma.\nAm J Emerg...","source_license":"CC0","license_restricted":false}