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

Quorrata Eynul Forhad, Ali Akbar Biswas, Sk Monirul Islam, Md Shah Alam
In: Bangladesh Journal of Obstetrics & Gynaecology · 2016 · vol. 29(1) , pp. 3–8 · doi:10.3329/bjog.v29i1.30436 · W2556678383
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This retrospective study found abdominal wall endometriosis, often presenting as a hypoechoic, vascular mass near a Cesarean section scar, is confirmed histopathologically.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This retrospective study evaluated clinical presentation and imaging characteristics of abdominal wall endometriosis in 12 surgically proven cases collected from 2008–2012, with all patients undergoing sonography including power Doppler; CT was done in one case and MRI in four, and image interpretation was reviewed in consensus. The key findings were that every patient had a prior cesarean section, all presented with focal pain near the scar (cyclic pain in three), nine had a palpable mass, and sonography detected 11 lesions that were hypoechoic, vascular, and solid (with cystic changes in one) with enhancement on CT/MRI. A major limitation is the small sample size and retrospective design, with incomplete cross-sectional imaging for most participants and power Doppler-guided puncture used in only half of cases for preoperative pathology. This paper is centrally about endometriosis — it specifically focuses on abdominal wall endometriosis and the sonographic imaging features, with emphasis on power Doppler findings near cesarean section scars.

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Abstract

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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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 Downloads 241 228

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Condition tags

endometriosis

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