TY - JOUR
T1 - Abdominal wall endometriosis
T2 - 12 years of experience at a large academic institution
AU - Ecker, Amanda M.
AU - Donnellan, Nicole M.
AU - Shepherd, Jonathan P.
AU - Lee, Ted T.M.
N1 - Publisher Copyright:
© 2014 Elsevier Inc. All rights reserved.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - Objective The objective of the study was to review patient characteristics and intraoperative findings for excised cases of abdominal wall endometriosis (AWE). Study Design A 12 year medical record search was performed for cases of excised AWE, and the diagnosis was confirmed on pathological specimen. Descriptive data were collected and analyzed.Results Of 65 patients included, the primary clinical presentation was abdominal pain and/or a mass/lump (73.8% and 63.1%, respectively). Most patients had a history of cesarean section (81.5%) but 6 patients (9.2%) had no prior surgery. Time from the initial surgery to presentation ranged from 1 to 32 years (median, 7.0 years), and time from the most recent relevant surgery ranged from 1 to 32 years (median, 4.0 years). Five patients (7.7%) required mesh for fascial closure following the resection of the AWE. We were unable to demonstrate a correlation between the increasing numbers of open abdominal surgeries and the time to presentation or depth of involvement. Age, body mass index, and parity also were not predictive of depth of involvement. There were increased rates of umbilical lesions (75% vs 5.6%, P <.001) in nulliparous compared with multiparous women as well as in women without a history of cesarean section (66.7% vs 1.9%, P <.001).Conclusion In women with a mass or pain at a prior incision, the differential diagnosis should include AWE. Although we were unable to demonstrate specific characteristics predictive for AWE, a large portion of our population had a prior cesarean section, suggesting a correlation.
AB - Objective The objective of the study was to review patient characteristics and intraoperative findings for excised cases of abdominal wall endometriosis (AWE). Study Design A 12 year medical record search was performed for cases of excised AWE, and the diagnosis was confirmed on pathological specimen. Descriptive data were collected and analyzed.Results Of 65 patients included, the primary clinical presentation was abdominal pain and/or a mass/lump (73.8% and 63.1%, respectively). Most patients had a history of cesarean section (81.5%) but 6 patients (9.2%) had no prior surgery. Time from the initial surgery to presentation ranged from 1 to 32 years (median, 7.0 years), and time from the most recent relevant surgery ranged from 1 to 32 years (median, 4.0 years). Five patients (7.7%) required mesh for fascial closure following the resection of the AWE. We were unable to demonstrate a correlation between the increasing numbers of open abdominal surgeries and the time to presentation or depth of involvement. Age, body mass index, and parity also were not predictive of depth of involvement. There were increased rates of umbilical lesions (75% vs 5.6%, P <.001) in nulliparous compared with multiparous women as well as in women without a history of cesarean section (66.7% vs 1.9%, P <.001).Conclusion In women with a mass or pain at a prior incision, the differential diagnosis should include AWE. Although we were unable to demonstrate specific characteristics predictive for AWE, a large portion of our population had a prior cesarean section, suggesting a correlation.
KW - abdominal wall endometrioma
KW - cutaneous endometriosis
KW - extrapelvic endometriosis
KW - incisional endometriosis
KW - scar endometriosis
UR - http://www.scopus.com/inward/record.url?scp=84907681226&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84907681226&partnerID=8YFLogxK
U2 - 10.1016/j.ajog.2014.04.011
DO - 10.1016/j.ajog.2014.04.011
M3 - Article
C2 - 24732005
AN - SCOPUS:84907681226
SN - 0002-9378
VL - 211
SP - 363.e1-363.e5
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 4
ER -