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Background: Abdominal wall endometriosis is a rare pathological entity. It presents as a tumor with pain, erythema, which worsens with Valsalva maneuvers., Objective: To show the experience and results in the management of the department of hernias and abdominal wall in a hospital of second level and to present review of the literature., Method: The files of patients treated in the department of hernias and abdominal wall, surgically treated with preoperative clinical and postoperative histopathological diagnosis of abdominal wall endometriosis were taken. The data was described using measures of central tendency and percentages., Results: Twenty-nine patients were identified, with an average age of 32.75 years, 68.9% reported cyclic catamenial pain associated with a tumor in the abdominal wall; a preoperative clinical diagnosis of abdominal wall endometriosis was made in 89.75%. Only one patient was reported with histopathological diagnosis of fibrolipoma. The totality of the patients referred cesarean section as previous surgery. No recurrences were reported., Conclusions: Abdominal wall endometriosis is the presence of ectopic endometrial tissue in any layer of the abdominal wall. Patients with this diagnosis are referred to the general surgeon presenting a tumor, however, the preoperative diagnosis rate is erroneous in most cases. Abdominal wall ultrasound is useful in diagnosis; tomography and magnetic resonance determine the extent of the disease. The treatment must be related to the extension of the disease and its recurrence is associated with the presence of positive margins., (Copyright: © 2019 Permanyer.)

Endometriosis, defined as the presence of endometrial glands and stroma outside the uterine cavity, is a chronic inflammatory condition that affects between 8 % and 44 % of women of reproductive age. Occasionally it presents as a sensitive mass in the abdominal wall, in relation to a surgical scar. On the other hand, in the most severe stage of endometriosis, intestinal involvement is common, and endometriotic disease of the appendix may be present even in appendices with macroscopically normal appearance. Simultaneous affectation of both locations is very rare. Nevertheless, treatment of choice is the excision of both lesions with safety margins. The aim of this manuscript was to report a case of simultaneous deep endometriosis affecting the total abdominal wall and vermiform appendix, resected in a single surgical procedure, which subsequently required abdominal wall repair with mesh plasty. Since desmoid tumors and endometriosis share similar clinical signs and unspecific imaging exams, both options should be considered in case of abdominal wall mass in female patients of childbearing age, especially if they have a history of uterine-related surgery. [ABSTRACT FROM AUTHOR]

Endometriosis (E) is defined as the presence of endometrial glands and endometrial stroma outside the uterus. Occasionally it presents as a sensitive mass in the abdominal wall (AW), in relation to a surgical scar (AWE). Although the treatment is surgical, there is scarce information regarding postoperative morbidity (POM) and recurrence of AWE. The aim of this study was to determine POM and recurrence in patients surgically resected by AWE. Case series of patients with AWE, consecutively submitted to surgery, at RedSalud Mayor Clinic, between 2011 and 2021. Outcome variables were POM and recurrence. Other variables of interest were surgical time, hospital stay and mortality. Patients were followed-up clinically. Descriptive statistics were used, applying central tendency and dispersion measures. 14 patients were intervened, with a median age of 33 years. Median of surgical time and hospital stay were 55 min and 2,5 days respectively. POM was 14.2 % (2 cases). With a median follow-up of 31 months no recurrence was verified. Although AWE is uncommon, these lesions should be suspected in women in fertile age with a palpable mass associated with a scar from gynecologic or obstetric surgery. The results obtained, in terms of POM and recurrence, were like international series. [ABSTRACT FROM AUTHOR]

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Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abdominal wall endometrioma is a condition rarely seen by surgeons. It represents a diagnostic challenge due to its similarity with other tumors. This entity occurs in fertile women and often appears two to five years after gynecological and obstetric surgical procedures. It must be considered when dealing with a cyclically painful nodule located in a laparotomy scar. The diagnosis is established by histological examination; most imaging tests determine the characteristics of the lesion, concomitant lesions and the intra-abdominal origin or location in the abdominal wall. The cases of two patients treated at the General Surgery Department of the María Eugenia González Comprehensive Diagnostic Center in the Capital District, Venezuela, are presented. Wide excision of the tissue and histological examination were performed, confirming the diagnosis. The postoperative course was uneventful. This case is presented given the rarity of this condition.

Antecedentes: La presencia de endometriosis de la pared abdominal (EPA) suele confundirse con otras patologías médico-quirúrgicas que aparecen en la misma zona. Objetivo: Evaluar las características clínicas de la EPA. Método: Se realizó un estudio retrospectivo de todas las pacientes hospitalizadas con el diagnóstico histopatológico de EPA entre enero de 1997 y diciembre de 2005. Resultados: Se encontraron 14 pacientes, con edad promedio de 33,2 años. Los principales síntomas fueron: dolor cíclico (71,4%), masa abdominal (100%), dispareunia (21,4%) y dismenorrea (42,8%). Todas la pacientes tuvieron al menos una cirugía ginecológica (2 con procedimientos laparoscópicos) u obstétrica (85,7% cesárea). Sólo una paciente se había diagnosticado previamente de endometriosis. Los síntomas comenzaron en promedio 3,5 años posteriores a la última cirugía. Las EPA tenían un tamaño promedio de 3,2 cm. El diagnóstico pre-operatorio fue correcto en el 64,3% de las pacientes. Los diagnósticos incorrectos correspondieron a 3 granulomas, una hernia inguinal y un lipoma. Todas las pacientes requirieron cirugía y en el 64,3% fue necesario la utilización de mallas polytetrafluoethyleno. Cuatro pacientes (28,5%) presentaron recurrencias. 60% de los diagnósticos iniciales incorrectos v/s 11,1% de los acertados recurrieron. Conclusiones: La EPA puede encontrarse en cicatrices tanto ginecológicas como obstétricas. Los síntomas comunes son masas con dolor cíclico. La ecografía de pared abdominal fue suficiente para enfrentar el diagnóstico diferencial. El diagnóstico pre-operatorio es importante para planificar la cirugía porque redujo las recurrencias. El tratamiento de elección es la cirugía con resección amplia de los bordesBackground: The presence of abdominal wall endometriosis (AWE) used to be confused with other surgical pathologies that may appear in these zones. Objective: To evaluate the AWE clinical characteristics. Method: Retrospective study of all the patients hospitalized with the histopathologycal diagnosis of AWE, between January 1997 and December 2005. Results: There was found AWE only in 14 patients. Their mean age was 33.2 years old. The symptoms were: cyclic pain (71.4%), abdominal wall mass (100%), dyspareunia (21.4%) and dysmenorrhea (42.8%). All patients had at least one gynecologic (2 patients with laparoscopic procedures) or obstetric surgery (85.7% had previous cesarean section). Only one patient had previously been diagnosed with pelvic endometriosis. Their symptoms started after an average of 3.5 years after surgery. The AWE had a mean size of 3.2 cm. The preoperative diagnosis was correct in 64.3%. The incorrect preoperative diagnoses were 3 granuloma, 1 inguinal hernia and 1 lipoma. All patients required surgery. 64.3% of the patients it was necessary a polytetrafluoethylene mesh. Four patients (28.5%) had AWE recurrences. 60% of the wrong initial diagnosis recurred versus 11.1% of the correct ones. Conclusion: AWE may be present in gynecologic or obstetric scars. Their common symptoms are masses with cyclic pain. Ultrasonography is enough to approach the differential diagnosis. The correct preoperative diagnosis is important to plan surgery and reduce recurrences. The surgical wide excision is the preferable treatment. Establishing clear endometriosis limits reduce the recurrences

La endometriosis de pared abdominal es una entidad rara que se presenta frecuentemente luego de una cirugía ginecológica. Se presentan tres casos de endometriosis parietal que fueron tratadas en los últimos dos años en el hospital Maciel de Montevideo. Se señalan sus aspectos etiológicos, diagnósticos, así como la importancia de su resección completa para lograr la curación definitiva.

INTRODUCTION: Endometriosis is described as the presence of functioning endometrial tissue outside of the uterine cavity. The abdominal wall is an uncommon site of extrapelvic endometriosis, which usually develops in association with a prior surgical scar. The rectus abdominis muscle endometriosis is an exceptional occurrence and only 21 cases have been reported in the medical literature. CASE REPORT: A 42 year-old woman who underwent caesarean section 4 years ago is admitted to the 'Hospital Aleman-Nicaraguense', Nicaragua, in August, 2013 because of a painful mass in the mesogastric region. The pain and swelling gradually increased in a cyclical manner and aggravated during the follicular stage of the menstrual cycle. The radiological imaging revealed an incisional hernia. Laparotomy revealed a 53 cm2 mass attached to the rectus abdominis muscle and to the connective tissue. Microscopy showed glandular spaces and endometrial stroma between a dense fibrous mass, therefore endometriosis diagnosis was made. DISCUSSION: Abdominal wall endometriosis is a clinical entity characterized by the presence of a tumor located somewhere near or inside a surgical scar. Lack of the classical symptoms and the unusual site can make diagnosis difficult. The treatment of choice is the complete surgical excision. The prognosis is good; however, malignant transformation of the rectovaginal septum has been reported. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Endometriosis is described as the presence of functioning endometrial tissue outside of the uterine cavity. The abdominal wall is an uncommon site of extrapelvic endometriosis, which usually develops in association with a prior surgical scar. The rectus abdominis muscle endometriosis is an exceptional occurrence and only 21 cases have been reported in the medical literature. CASE REPORT: A 42 year-old woman who underwent caesarean section 4 years ago is admitted to the ?Hospital Aleman-Nicaraguense?, Nicaragua, in August, 2013 because of a painful mass in the mesogastric region. The pain and swelling gradually increased in a cyclical manner and aggravated during the follicular stage of the menstrual cycle. The radiological imaging revealed an incisional hernia. Laparotomy revealed a 53 cm2 mass attached to the rectus abdominis muscle and to the connective tissue. Microscopy showed glandular spaces and endometrial stroma between a dense fibrous mass, therefore endometriosis diagnosis was made. DISCUSSION: Abdominal wall endometriosis is a clinical entity characterized by the presence of a tumor located somewhere near or inside a surgical scar. Lack of the classical symptoms and the unusual site can make diagnosis difficult. The treatment of choice is the complete surgical excision. The prognosis is good; however, malignant transformation of the rectovaginal septum has been reported. [ABSTRACT FROM AUTHOR]

Copyright of Revista Chilena de Obstetricia y Ginecología is the property of Revista Chilena de Obstetricia y Ginecologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCCIÓN: La endometriosis de la pared abdominal se define como la presencia de tejido endometrial ectópico superficial al peritoneo parietal, cuyo origen puede asociarse a procedimientos quirúrgicos ginecológicos previos. Su prevalencia es baja, alrededor del 0.03%, siendo el primer caso aislado en nuestra institución, se hace menester su reporte y revisión bibliográfica. MATERIALES Y MÉTODOS: Estudio descriptivo. Reporte de un caso y breve revisión bibliográfica del tema. RESULTADOS: La endometriosis es clásicamente definida como la presencia de glándulas endometriales y estroma por fuera de la cavidad uterina. Su prevalencia en mujeres de edad fértil es del 10%, relacionada con infertilidad en un 35-50%. El tejido endometrial ectópico se localiza por lo general en la pelvis, pero también puede encontrarse en los pulmones, intestino, uréteres, cerebro y pared abdominal. La endometriosis de la pared abdominal (EPA) es cualquier endometrio ectópico superficial al peritoneo, la definición incluye lesiones que pueden o no estar relacionadas con procedimientos quirúrgicos previos. Está asociada con cesárea en el 57% e histerectomía en el 17%. El tiempo promedio entre la cirugía y la presentación de los síntomas es de 2.1 a 3.6 años y la recurrencia después de la resección es del 4.3%. Datos de diferentes estudios afirman que la prevalencia es tan baja como del 0.03%-1.08% dependiendo de la muestra y lugar de estudio. La clínica más común es una masa palpable que se da en el 96% de las pacientes, seguido por dolor abdominal en un 86% y dolor cíclico asociado a la menstruación en un 57%. Presentamos el caso de una paciente de sexo femenino de 37 años de edad, con antecedente de tres cesáreas hace 3, 6 y 10 años; quien presento cuadro clínico de sensación de masa en pared abdominal, acompañado de dolor cíclico y crecimiento de masa relacionado a periodos menstruales. Reporte de ecografía abdominal reporto masa heterogénea vascularizada de 4x5cm. Operada en nuestra institución donde se evidencia masa endometrial que infiltraba los rectos abdominales, posteriormente se confirmó el diagnóstico con el estudio histopatológico. CONCLUSIÓN: La endometriosis abdominal es una entidad poco frecuente en la práctica médica. Un alto índice de sospecha debe tenerse en cuenta en el caso de una mujer que se presenta con dolor abdominal incapacitante localizado en la pared abdominal, con antecedente de procedimientos quirúrgicos ginecológicos previos. Esta patología puede ser confundida con muchas otras entidades quirúrgicas; por lo que recurrir a estudios paraclínicos puede ser fundamental en la certeza diagnóstica. Disponer de estudios de imagen y la precisión de la biopsia con aguja fina son estrategias que nos acercan al diagnóstico definitivo. Posterior al tratamiento quirúrgico, se debe hacer seguimiento de estas pacientes, por el riesgo de recurrencia. [ABSTRACT FROM AUTHOR]