A case report on Spontaneous Abdominal Wall Endometriosis

Ummul Nusrat Zahan, GWM Zahidul Hasan
In: Bangladesh Critical Care Journal · 2023 · vol. 11(1) , pp. 51–53 · doi:10.3329/bccj.v11i1.66034 · W4377194785
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes a rare instance of spontaneous abdominal wall endometriosis in an unscarred area below the umbilicus, diagnosed by pathology and treated with surgical excision.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This paper is a case report of spontaneous abdominal wall endometriosis describing a patient with cyclic infra-umbilical pain that later became constant and severe, with a midline lesion below the umbilicus that initially took time to diagnose because of its unusual site and presentation despite an earlier caesarean section. Intraoperatively, the mass was seen extending to the peritoneum and was removed by wide local excision, and pathology showed endometrial glands surrounded by endometrial stroma and fibrous scar tissue. The authors note that spontaneous abdominal wall endometriosis is rare and cite that spontaneous endometriomas are typically diagnosed by pathology and treated with surgical excision, with the main limitation being the single-patient design inherent to a case report. This paper is centrally about endometriosis — it specifically reports a case of spontaneous abdominal wall endometriosis in an unscarred area.

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Abstract

Endometriosis is the presence of endometrial glands and stroma outside the uterus. Endometriosis is the commonestgynaecological problem; it affects 7 to 10% women in reproductive age group. Spontaneous abdominal wallendometriosis (AWE) is any ectopic endometrium found superficial to the peritoneum without the presence of anyprevious scar. In our case study, though the patient had a caesarean section, the endometriosis developed in unscarredarea. It was located below the umbilicus in the midline, which is a common site for spontaneous abdominalendometriomas. Initially the patient had cyclic infra-umbilical pain, gradually it became constant and severe. Due toirregular follow up and unusual site and presentation of the lesion, it took a long time to diagnose the condition. Duringoperation the mass was spotted in the midline and extend up to the peritoneum. It was taken out by wide local excision.Pathology revealed endometrial glands surrounded by a disintegrating mantle of endometrial stroma and fibrous scartissue in which there was a scattering of leucocytes. Spontaneous AWE is rare, accounting for 20% of all AWEs.Spontaneous endometriomas are usually diagnosed by pathology and the treatment of choice is surgical excision Bangladesh Crit Care J March 2023; 11 (1): 51-53

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Condition tags

endometriosis

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