Abdominal wall endometriosis. An overlooked diagnosis

Khammash MR, Muhammad R. Khammash, Abdel K. Omari, Omari AK, Gasaimeh GR, Ghazi R Gasaimeh, Kamal E Bani-Hani, Kamal E. Bani‐Hani, Bani-Hani KE
Saudi medical journal · 2003 · vol. 24(5) , pp. 523–525 · doi:10.15537/1658-3175.2046 · PMID:12847630 · W1611002872
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This study reviewed 14 cases of abdominal wall endometriosis after cesarean section, finding it presented as painful scar masses with a mean onset of 2 years and an incidence of 0.2%.

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This study reviewed 14 cases of abdominal wall endometriosis treated between 1997 and 2002 at two hospitals in Jordan to characterize incidence after cesarean section and how patients presented to general surgeons. Using retrospective chart review, the authors documented symptom patterns, time to noticing the mass (mean 2 years), provisional diagnoses (often stitch granuloma, incisional hernia, or abdominal wall tumor), and investigations for pelvic endometriosis. All patients had a painful scar-related mass, with 5 reporting pain exacerbation during menstruation, and histopathology confirmed abdominal wall endometriosis; none had pelvic endometriosis and none recurred after wide local excision. The incidence was estimated at about 0.2% of cesarean sections in that period. This paper is centrally about endometriosis—specifically abdominal wall endometriosis arising in post-cesarean scars.

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Abstract

OBJECTIVE: To study the incidence of abdominal wall endometriosis after cesarean section and its presentation to the general surgeon. METHODS: Fourteen patients were treated for abdominal wall endometriosis during the period June 1997 to May 2002 at Princess Basma Teaching Hospital and King Abdulla University Hospital, Irbid, Jordan. The patient's files were reviewed to see their way and time of presentation after cesarean section, provisional diagnosis made and operative procedures performed. Symptoms suggestive of and investigations carried out to detect pelvic endometriosis were also looked for and recorded. RESULTS: Fourteen patients were treated within 5 years; all had painful scar-related mass. The pain was exacerbating during menstruation in 5. The clinical diagnosis was stitch granuloma in 3; incisional hernia in 3, abdominal wall tumor in 3 and abdominal wall endometrioma in 5 patients. The mean time for the mass to be noticed by the patient was 2 years. They were treated with wide local excision. Histopathological examination proved the diagnosis of abdominal wall endometriosis. None had evidence of pelvic endometriosis and none of them had recurrence. The incidence of the disease is around 0.2% of the cesarean sections performed during the same period. CONCLUSION: The treating physician should keep in mind abdominal wall endometriosis as a possible cause of post cesarean section scar-related masses.
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Abstract OBJECTIVE: To study the incidence of abdominal wall endometriosis after cesarean section and its presentation to the general surgeon. METHODS: Fourteen patients were treated for abdominal wall endometriosis during the period June 1997 to May 2002 at Princess Basma Teaching Hospital and King Abdulla University Hospital, Irbid, Jordan. The patient9s files were reviewed to see their way and time of presentation after cesarean section, provisional diagnosis made and operative procedures performed. Symptoms suggestive of and investigations carried out to detect pelvic endometriosis were also looked for and recorded. RESULTS: Fourteen patients were treated within 5 years; all had painful scar-related mass. The pain was exacerbating during menstruation in 5. The clinical diagnosis was stitch granuloma in 3; incisional hernia in 3, abdominal wall tumor in 3 and abdominal wall endometrioma in 5 patients. The mean time for the mass to be noticed by the patient was 2 years. They were treated with wide local excision. Histopathological examination proved the diagnosis of abdominal wall endometriosis. None had evidence of pelvic endometriosis and none of them had recurrence. The incidence of the disease is around 0.2% of the cesarean sections performed during the same period. CONCLUSION: The treating physician should keep in mind abdominal wall endometriosis as a possible cause of post cesarean section scar-related masses. Article Type Research Article First Page 523 Last Page 525 Recommended Citation Khammash, Muhammad R.; Omari, Abdel K.; Gasaimeh, Ghazi R.; and Bani-Hani, Kamal E. (2003) "Abdominal wall endometriosis. An overlooked diagnosis," Saudi Medical Journal: Vol. 24: Iss. 5, Article 15. DOI: https://doi.org/10.15537/1658-3175.2046

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Condition tags

endometriosisendometrioma

MeSH descriptors

Abdominal Wall Cesarean Section Endometriosis Adult Cesarean Section Endometriosis Endometriosis Female Humans Middle Aged

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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