Abdominal wall endometriosis: A monocentric continuous series and review of the literature

Abstract

Introduction:

Endometriosis is characterized by the presence of endometrial cells anywhere outside the uterine cavity. Endometriosis has been encountered on surgical scars especially resulting from a cesarean section recently. Our aim was to investigate the patients with abdominal wall endometriosis in our clinics where all the patients having this disease are managed via surgical resection. We also compared them with the patients presented in the literature.

Methods:

A study was conducted on the patients with histopathological diagnosis of abdominal wall endometriosis as a case series. All the subjects were analyzed through a comprehensive medical assessment including documentation of the detailed history and physical and gynecological examination based on the patients’ medical records.

Results:

A total of 53 patients diagnosed with abdominal wall endometriosis were included in this study. The mean age and the mean body mass index of the patients were 32.6 ± 6.5 years and 25.2 ± 3.5 kg/m², respectively. A total of 49 patients had at least one operation history, mainly cesarean section. The most common sites for abdominal wall endometriosis were skin and the region containing the rectus abdominis muscle and rectus sheath, 56.6% and 18.9% respectively. The main symptom was the pain getting worse during menstruation and the presence of a mass in all patients. The main diagnostic tools in all patients were detailed history and physical examination, ultrasonography, and then histopathological confirmation after surgical excision.

Conclusion:

Abdominal wall endometriosis is a common diagnosis mainly due to increased cesarean section rate. Clinical suspicion has the most important place in correct diagnosis and management of abdominal wall endometriosis.

Keywords

Extrapelvic endometriosis scar endometriosis abdominal wall endometriosis vaginal endometriosis

Get full access to this article

View all access options for this article.

References

Çelik

Dogan

Okyay

et al . Effect of laparoscopic excision of endometriomas on ovarian reserve: serial changes in the serum antimüllerian hormone levels. Fertil Steril 2012; 97(6): 1472–1478.

Speroff

Fritz

. Endometriosis. In: Fritz

Speroff

(eds) Clinical gynecologic endocrinology and infertility. 8th ed. Philadelphia, PA: Lippincott Williams & Wilkin, 2011, pp. 1221–1248.

Davis

Goldberg

. Extra pelvic endometriosis. Semin Reprod Med 2017; 35(1): 98–101.

Juneja

Tandon

Chopra

. Successful pregnancy after excision of cesarean scar endometriosis with uterovesicocutaneous fistula: a rare case report. Int J Appl Basic Med Res 2016; 6(4): 300–302.

Nominato

Prates

Lauar

et al . Cesarean section greatly increases risk of scar endometriosis. Eur J Obstet Gynecol Reprod Biol 2010; 152: 83–85.

Ellenson

Pirog

. The female genital tract. In: Kumar

Abbas

Fausto

et al . (eds) Robbin’s and cotran pathologic basis of disease. 8th ed. Philadelphia, PA: Saunders, 2010, pp. 1028–1029.

Matalliotakis

Goulielmos

Kalogiannidis

et al . Extra pelvic endometriosis: retrospective analysis on 200 cases in two different countries. Eur J Obstet Gynecol Reprod Biol 2017; 217: 34–37.

Brătilă

Ionescu

Badiu

et al . Umbilical hernia masking primary umbilical endometriosis—a case report. Rom J Morphol Embryol 2016; 57(2 Suppl.): 825–829.

Lopez-Soto

Sanchez-Zapata

Martinez-Cendan

et al . Cutaneous endometriosis: presentation of 33 cases and literature review. Eur J Obstet Gynecol Reprod Biol 2018; 221: 58–63.

10.

Nigam

Omhare

Sharma

. Fine-needle aspiration cytology of a cesarean scar endometriosis. Ci Ji Yi Xue Za Zhi 2017; 29(4): 232–234.

11.

Chiaramonte

Castorina

et al . Thrombosis of iliac vessels, a rare complication of endometriosis: case report and review of literature. J Adv Res 2017; 8(1): 1–5.

12.

Osório

Alves

Pereira

et al . Obturator internus muscle endometriosis with nerve involvement: a rare clinical presentation. J Minim Invasive Gynecol 2018; 25(2): 330–333.

13.

Machairiotis

Stylianaki

Dryllis

et al . Extrapelvic endometriosis: a rare entity or an under diagnosed condition? Diagn Pathol 2013; 8: 194.

14.

Ajao

Einarsson

. Management of endometriosis involving the urinary tract. Semin Reprod Med 2017; 35(1): 81–87.

15.

Pathan

Dinesh

Rao

. Scar endometriosis. J Cytol 2010; 27: 106–108.

16.

Djaković

Vuković

Bolanča

et al . Abdominal wall endometriosis eleven years after cesarean section: case report. Acta Clin Croat 2017; 56(1): 162–165.

17.

Ling

Lefebvre

. Extrapelvic endometriosis: a case report and review of the literature. J Soc Obstet Gynecol Can 2000; 22(2): 97–100.