Abdominal Wall Endometriosis:a Review of 65 Cases

Objective:To explore the clinical characteristics,treatment as well as prevention of abdominal wall endometriosis(AWE).Methods:65 cases of AWE treated at Tianjin Central Hospital of Obstetrics and Gynecology from year 2008 to 2009 were reviewed.The average age was (30.7±3.6)years,range from 23 to 37 years.All of whom undergone the first cesarean section presented with pain and mass of cesarean scar 8 to 36 months after surgery,were hospitalized 9 to 72 months after surgery.The size of mass was from 1 cm × 2 cm to 4 cm × 4.5 cm.The characteristics of mass include unclear edge,solid,hard,tenderness and inmovable.In 23 cases,CA125 were mildly elevated.Results:All the cases were secondry to cesarean section.Of 65 cases with AWE,49 were located in adipose layer,13 cases were as deep as rectus abdominis.Peritoneal were invaded in 3 cases.All cases were received surgical treatment while in 5 cases which lesion diameter 4 cm were given gonadotropin releasing hormone agonist (GnRHa) treatment for 3 times (per 28-32 day)prior to surgery.No recurrence was observed during 4-20 month follow-up and postoperative administration for 3 months.Conclusions:AWE could be diagnosed according to its medical history,typical clinical manifestations as well as gynecological check-up.Surgical treatment is the preferred choice.A complete excision with clear margin is very important.Medicine treatment after operation can prevent recurrence.Appropriately preventive measure is important during cesarean section.