Abdominal Wall Endometriosis

Abstract

The purpose of this presentation is to show the diagnostic characteristics of abdominal wall endometriosis, one of the extraperitoneal localizations of this disease, not widely described. We evaluated 11 patients examined with US between March 2007 and January 2011 who came to our service with pain located in the anterior abdominal wall. All of them suffered surgery, and histopathologic diagnosis was endometriosis. All of the patients (range 24-33 years) had history of surgery in the pelvis (4 laparoscopic surgeries of ovarian endometriosis and 7 caesareans). They all presented with abdominal pain, exacerbated in the menstrual period. At the US examination, they all presented a hypoechoic, solid or mixed lesion in the abdominal wall, between 18 and 25 mm, well-delimited edges and located next to the scar in the rectus abdominis muscles. The differential diagnoses to be considered are granuloma, tumor, hernia and haematoma. The surgical treatment consisted in complete resection of the lesion with histopathological confirmation. To diminish or avoid recurrence, resection must was performed with wide margins. In female patients with abdominal pain, especially if it worse during the menstrual period and they have a history of abdominal surgeries, the diagnosis of endometrioma should be considered if the US reveals a well-delimited solid or mixed mass in the abdominal wall.