Clinical and Sonographic Evaluation of Abdominal Wall Endometriosisand Their Correlation with Surgical Findings

Document Type : Original Article

Authors

1 Associate Professor of Radiology, Mashhad University of Medical Sciences, Mashhad, Iran

2 MD., Mashhad, Iran.

Abstract

Introduction: Abdominal wall endometriosis is a complication of cesarean section, which can be diagnosed by sonography. The purpose of this study was to evaluate the clinical and sonographic findings of abdominal wall endometriosis and comparative these by surgical finding.
Material and Methods: In a retrospective study, we evaluated 19 patients who complained of suprapubic pain and palpable mass at the site of previous cesarean section. All patients were evaluated by sonography and in six of them color Doppler sonography was performed. Sonographic findings were compared with surgical findings.
Results: There was history of one cesarean section in 16 patients and twice in 3 patients. All patients complained of pain around the scar. In 13 patients the pain was permanent, but in 6 of them was cyclic and intermittent, which increased around the menstrual period. In 15 patients there was a palpable mass around the line of cesarean section. In all patients a mass was detected by sonography, which was solid and hypoechoic in 17 patients and solid and isoechoic in two patients. In six patients color Doppler sonography showed variable arterial and venous flow. In three of patients color Doppler sonography was performed around the menstrual period, which showed more prominent arterial and venous flow accompanied by some small echo free changes. Surgical findings were available in 15 patients, which were comparable to the sonographic findings.
Conclusion: Abdominal wall endometriosis often presents as palpable masses and permanent supra pubic pain. In Doppler sonographic evaluation it appears as a hypoechoic mass with a variable flow pattern.

Keywords

References

1. Patterson GK, Winburn GB. Abdominal wall endometriomas: report of eight cases. Am Surg
1999 Jan;65(1):36-9
2. Koger KE, Shatney CH, Hodge K, McClenthan JH: Surgical scar endometrioma. Surg Gynecol
Obstet 1993 Sep;177(3):243-6.
3. Seydel AS,Sickel JZ, Warner ED, Sax HC.Extrapelvic endometriosis: diagnosis and treatment
Am J Surg 1996 Feb;171(2):239.
4. Dwivedi AJ, Agrawal SN, Silva YJ. Abdominal wall endometriomas. Dig Dis Sci 2002
Feb;47(2):456-61.
5. Blanco RG, Parithivel VS,Shah AK, Gumbs MA, Schein M, Gerst PH. Abdominal wall
endometriomas: Am J Surg 2003 Jun;185(6):596-8.
6. Simsi A, Thorner K, Waisman J, Gangiarella J. Endometriosis in abdominal scars: a report of
three cases diagnosed by fine-needle aspiration biopsy. Am Surg. 2001 Oct;67(10):984-6.
 
7. Ideyi SC, Schein M, Niazi M,Gerst PH, Spontaneous endometriosis of the abdominal wall. Dig
Surg 2003; 20(3):246-8.
8. Singh KK, Lessells AM, Adam DJ, Jordan C, Miles WF, Macintyre IM, et al. Presentation of
endometriosis to general surgeons: a 10-year experience. Br J Surg 1995 Oct;82(10):1349-51.
9. Woodward PJ, Sohaey R, Mezzatti TP Jr. Endometriosis: radiologic-pathologic correlation.
Radiographics 2001 Jan; 21(1):193-216.
10. Wolf C Obrist P, Ensinger C. Sonographic features of abdominal wall endometriosis. AJR Am J
Roentgenol.1997 Sep;169(3):916-7.
11. Francica G, Giardiello C, Angelone G, Cristiano S, Finelli R, Tramontano G. Abdominal wall
endometriosis near cesarean delivery scars: sonographic and color doppler findings in a series of
12 patients. J ultrasound Med 2003 Oct;22(10):1041-7.
12. - Lahiri AK, Sharma K, Busiri N. Endometriosis of the uterine cesarean section scar: A case
report. Indian J Radiol Imaging 2008;18:66-68.
13. Park SB, Kim JK, Cho KS. Sonography of endometriosis in infrequent sites. J Clin Ultrasound.
2008 Feb;36(2):91-7.
14. Teng CC, Yang HM, Chen KF, Yang CJ, Chen LS, Kuo CL. Abdominal wall endometriosis: an
overlooked but possibly preventable complication. Taiwan J Obstet Gynecol. 2008
Mar;47(1):42-8.

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