%0 Journal Article
%T A Surgeon¡¯s Perspective of Abdominal Wall Endometriosis at a Caesarean Section Incision: Nine Cases in a Single Institution
%A Eun Mee Oh
%A Won-Suk Lee
%A Jin Mo Kang
%A Sang Tae Choi
%A Keon Kuk Kim
%A Woon Kee Lee
%J Surgery Research and Practice
%D 2014
%R 10.1155/2014/765372
%X Abdominal wall endometriosis in a Caesarean section scar (AEC) is an infrequent type of extrapelvic endometriosis which rarely transforms into a malignant lesion. A painful mass located in the scar of a Caesarean section is a typical sign of AEC. This condition is diagnosed preoperatively using imaging modalities such as computed tomography and ultrasonography, as well as fine-needle aspiration. Although AEC has typical signs, general surgeons often misdiagnose it due to its rarity. Herein, we report our experience of AEC in a single institution. 1. Introduction Extrapelvic endometriosis, an uncommon form of the disease, can affect unusual sites including the urinary tract, gastrointestinal tract, and thorax. The incidence of abdominal wall endometriosis in a previous Caesarean section (C/S) scar has been reported at ~1-2% in patients undergoing lower abdominal surgery [1]. Despite its rarity, several reports on abdominal wall endometriosis in a Caesarean section scar (AEC) have been published. A tender and painful abdominal wall mass is considered suggestive of AEC in females of reproductive age with a previous history of C/S [1, 2]. Imaging studies including ultrasonography (USG) and computed tomography (CT) can aid the diagnosis of AEC; however, the condition is often misdiagnosed and referred to general surgeons [3]. Herein, we report nine cases of AEC from the perspective of a general surgeon. 2. Case Report The study data were gathered from the electronic medical records from the period 2002 to 2013, during which a total of nine cases of AEC were confirmed histologically. Among them, six female patients presented to general surgeons and the remaining three visited a gynaecology clinic due to their chief complaint. Nine clinicians, including three gynaecologists and six general surgeons, evaluated and treated these nine patients. All patients were premenopausal and between 29 and 40 years of age. Five patients had undergone C/S twice and the remaining four patients had had one C/S. One of the patients had a history of preeclampsia and the other eight had no notable obstetric or gynaecologic history. Pfannenstiel skin incisions and tender masses were found in the previous C/S scars of all patients. In four of the patients, menstruation was associated with tenderness in the C/S scar. The duration of clinical symptoms varied from 3 months to 3 years. Computed tomography (CT) was used in five patients and ultrasonography (USG) was used in three patients to evaluate the lesions. No imaging was used in the remaining patient, but the first impression of
%U http://www.hindawi.com/journals/srp/2014/765372/