Rectus abdominis endometriosis; clinical presentation and imaging features; a retrospective stuady of ten cases.

Neoplasia, Biopsy, Ultrasound-Colour Doppler, MR, CT, Pelvis, Genital / Reproductive system female, Abdomen Authors: J. Saad1, Y. M. Abdou2, F. Marrakchi3; 1Monastir, TN/TN, 2Nejran/SA, 3Monastir/TN DOI: 10.1594/ecr2013/C-0798 Learning objectives After completing this presentation, participants will be able to 1- Describe the typical and unusual clinical manifestations that can be seen with rectus muscle abdominis endometriosis. 2- Outline the proposed mechanisms of pathogenesis of rectus muscle endometriosis. 3- Describe the different roles of US, color Doppler study, CT scan and MR imaging in the investigation of rectus muscle abdominis endometriosis.

Endometriosis, a disorder affecting as many as 5-10% of women of childbearing age, is defined as the presence of functional endometrial glands and stroma outside the uterine cavity (1). The extra pelvic implantation of endometrial tissue has been described in virtually every organ. The abdominal wall is an uncommon site of extra pelvic endometriosis, which usually develops in a previous surgical scar. The prevalence of surgically proven endometriosis in scars was up to 1.6 % (2). Endometriosis of the rectus abdominis muscle is an exceptional... Imaging findings OR Procedure details Patients and methods: This is a retrospective study of 10 surgically-proven cases of rectus abdominis muscle endometriosis, seen over a 5-year period from 2007 to 2012 that were collected from our institution (Nejran Armed Forces Hospital, Saudi Arabia). All cases were reviewed as regards history, clinical examinations, investigations and management employed. Sonographic examination was performed in all patients using 3.5- and 5.0-MHz convex-array and 7.5-MHz and 12-15 MHz linear-array transducers (Antares, Siemens Medical Solutions and E9 General electric medical system, GE). Power Doppler sonography was...

Rectus abdominis endometriosis is often misdiagnosed because it may occur years after the Caesarean section, the pain is often non-cyclic in nature and there is not always a palpable mass. Radiological finding of a solid mass in the rectus muscle is not pathognomonic of endometriosis, but if located close to a Caesarean section scar it should be of prime consideration in the differential diagnosis. The final diagnosis of endometriosis rests on microscopic examination of the lesion. Surgical treatment is the main stay of cure for...

References: 1. Horton JD, Dezee KJ, Ahnfeldt EP, Wagner M. Abdominal wall endometriosis: A surgeon’s perspective and review of 445 cases. Am J Surg 2008; 196: 207–212. 2. Hashim H, Shukri S: Abdominal wall endometriosis in General Surgery. The Internet Journal of Surgery.2002.volume3 number 2:1-5 3. Tomas E,Martin A, Garfia C,Gomez FS, Morillas JD,Tortajada GC, et al. Abdominal wall endometriosis in absence of previous surgery.J Ultrasound Med1999;18:373-4 4. Coley BD, Casola G. Incisional endometrioma involving the rectus abdominis muscle and subcutaneous tissues: CT appearance. AJR... Personal Information DR JAMEL SAAD. ASSISTANT PROFESSOR IN MONASTIR MEDICAL COLLEGE.TUNISIA. CONSULTANT RADIOLOGIST AND HEAD OF RADIOLOGY DEPARTMENT IN NEJRAN ARMED FORCES HOSPITAL PROGRAM. PO BOX 1002. NEJRAN. SAUDI ARABIA.