Abdominal wall endometriosis: A challenging iatrogenic disease.

Mohamed Radhouane Rachdi,Mohamed Aymen Ferjaoui,Khaled Neji,Slim Khedhri,Kais Abdessamia,Ramzi Arfaoui,Kmar Hajjami,Raja Azri,Monia Malek,Mohamed Amine Hannechi,Manel Benghalia

doi:10.1016/j.ijscr.2021.106507

Abstract

Introduction and importanceAbdominal wall endometriosis is a rare clinical condition associated with abdominal pain and psychologic disorders. It's pathophysiology remains unclear. Clinical history and imaging findings are necessary for the diagnosis. Its management is challenging, and requires close collaboration between gynaecologists and visceral surgeons specially in complex procedures. The aims of our study are to present risk factors, clinical presentation, imaging findings and management features. It was a retrospective descriptive study including fifteen patients presenting abdominal wall endometriosis. Data about age, medical history, imaging findings, surgical procedures and outcome are reported.Cases presentationFifteen women were included in our study. The most common symptom was cyclic abdominal pain. Twelve of them had history of caesarean section, and three had history of myomectomy. All patients underwent ultrasound and MRI. We performed surgical excision to all cases. One patient needed large excision with abdominoplasty procedure.Clinical discussionAbdominal wall endometriosis is a rare clinical condition with unclear pathophysiology. It occurs frequently after gynaecologic or obstetric surgery. Most reported complaint was catamenial abdominal pain with abdominal wall mass. Ultrasonography, computed tomography and MRI are useful for diagnosis, specially to eliminate differential diagnoses. Abdominal wall endometriosis management is based on surgery. Excision goals are to remove the mass and to confirm histological diagnosis of parietal endometriosis.ConclusionParietal endometriosis is a rare and challenging condition with unclear pathophysiology. It requires specific management. This pathology will be encountered more frequently considering the increasing rate of caesarean section.

Highlights

Introduction and importanceAbdominal wall endometriosis is a rare clinical condition associated with abdominal pain and psychologic disorders
We reviewed all cases of abdominal wall endometriosis in the last three years and managed in two gynaecologic surgery centers: Department B of gynaecologic surgery of Tunis maternity center and Maternity department of Tunis military hospital
Our study aims to assess clinical, diagnostic and therapeutic features of abdominal wall endometriosis

Summary

Introduction

Introduction and importanceAbdominal wall endometriosis is a rare clinical condition associated with abdominal pain and psychologic disorders. The aims of our study are to present risk factors, clinical presentation, imaging findings and management features It was a retrospective descriptive study including fifteen patients presenting abdominal wall endometriosis. Clinical discussion: Abdominal wall endometriosis is a rare clinical condition with unclear pathophysiology It occurs frequently after gynaecologic or obstetric surgery. Conclusion: Parietal endometriosis is a rare and challenging condition with unclear pathophysiology It is characterized by the development of ectopic endometrial cells and stroma in abdominal wall layer It occurs commonly after surgical procedures such as caesarean section or myo mectomy [1]. The incidence of abdominal wall endometriosis is increasing because of the high rate of caesarean section [1] This challenging and rare condition is associated with chronic pelvic pain and psychologic disorders

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