GS26P
ABDOMINAL WALL ENDOMETRIOMA FOLLOWING CAESAREAN SECTION

Purpose Endometriosis is defined as the presence of aberrant endometrial tissue outside of the uterus that responds to stimulation by ovarian hormones. A large, circumscribed mass of such tissue is commonly termed an endometrioma. Abdominal wall endometriomas in association with caesarean section scars have been reported repeatedly in the obstetrics and gynaecology literature, but rarely in general surgical journals. Methodology In this paper, six patients are reviewed who presented between 2001 and 2006 with painful, tender nodules in and around caesarean section scars. Of these, four reported exacerbation of symptoms during, or just prior to menstruation. One patient had experienced 12 years of symptoms, previously attributed to intra‐abdominal adhesions. Results All patients had their scar nodules excised. Five procedures were performed electively. One patient underwent emergency exploration of her caesarean scar for possible incarcerated incisional hernia. Ectopic endometrial tissue was seen in the histological specimens of all patients. Four patients reported resolution of their symptoms following surgery. One patient had ongoing symptoms post‐operatively, with an additional mass lesion seen on ultrasound consistent with a second endometrioma. One patient did not attend follow‐up. Conclusion General surgeons are commonly required to assess and manage abdominal wall masses, and should have an awareness of endometrioma in the differential diagnosis when such a lesion is seen in association with a caesarean section scar. Wide excision is usually very effective at alleviating symptoms of abdominal wall endometrioma.