Abdominal Wall Endometriosis: Case Series and Review of the Literature

Yıl 2019, Cilt: 16 Sayı: 1, 1 - 3, 01.01.2019

Oğuzhan Kuru

Öz

Aim: To determine the clinico-pathological features of the abdominal wall endometriosis and review of the the literature.Material And Methods: We documented a case series of 9 patients who were diagnosed and underwent surgical management for abdominal wall endometriosis at our clinic between 2014 and 2017.Results: All but one of the patients had a history of cesarean section. Most of the patients 7/9, %77.7 had cyclical pain under the incision. Wide excision of the lesion was performed in all patients. After pathological examination, mean diameter of the endometriotic lesions was 4 cm. Median follow-up was 20 months 4-48 months, range and none of the patients relapsed during this period.Conclusion: Based on history and sonographic examination, it is reliable to diagnose abdominal wall endometriosis. Wide excision is a curative treatment.

Anahtar Kelimeler

Endometriosis, scar, abdominal wall

Karın Duvarı Endometriozisi: Vaka Serisi ve Literatür Derlemesi

Öz

Amaç: Karın duvarı endometriozisinin klinik ve patolojik özelliklerini belirlemek ve literatürü gözden geçirmek.Gereç ve Yöntemler: 2014 ve 2017 yılları arasında kliniğimizde tanı konulup cerrahi müdahale yapılan 9 hastalık vaka serisini gözden geçirdik.Bulgular: Hastalardan biri hariç hepsinde sezaryan doğum öyküsü vardı. Hastaların çoğunda 7/9, %77.7 insizyon altında siklik ağrı şikayeti mevcuttu. Tüm hastalarda lezyonun geniş eksizyonu yapıldı. Endometriotik lezyonların patoloji ile ortalama çapı 4 cm bulundu. 20 ay medyan takip süresince 4-48 ay hiçbir hastada nüks gorülmedi.Sonuç: Öykü ve sonografik incelemeye dayanarak, karın duvarı endometriozisini teşhis etmek güvenilirdir. Geniş eksizyon, iyileştirici bir tedavidir.

Anahtar Kelimeler

Endometriozis, skar, karın duvarı

Kaynakça

• Khan Z, Zanfagnin V, El-Nashar SA, Famuyide AO, Daftary GS, Hopkins MR. Risk Factors, Clinical Presentation, and Outcomes for Abdominal Wall En- dometriosis. J Minim Invasive Gynecol. 2017;24:478-84.
• Ideyi SC, Schein M, Niazi M, Gerst PH. Spontaneous endometriosis of the abdominal wall. Dig Surg. 2003;20(3):246-8.
• Tomas E, Martin A, Garfia C, Sanchez Gomez F, Morillas JD, Castellano Tortajada G, ve ark. Abdominal wall endometriosis in absence of previous surgery. J Ultrasound Med. 1999 May;18(5):373-4.
• Ozel L, Sagiroglu J, Unal A, Unal E, Gunes P, Baskent E, ve ark. Abdominal wall endometriosis in the cesarean section surgical scar: a potential diag- nostic pitfall. J Obstet Gynaecol Res. 2012;38(3):526-30.
• Mistrangelo M, Gilbo N, Cassoni P, Micalef S, Faletti R, Miglietta C, ve ark. Surgical scar endometriosis. Surg Today. 2014;44(4):767-72.
• Horton JD, Dezee KJ, Ahnfeldt EP, Wagner M. Abdominal wall endomet- riosis: a surgeon’s perspective and review of 445 cases. Am J Surg. 2008;196(2):207-12.
• Zhang J, Liu X. Clinicopathological features of endometriosis in abdo- minal wall--clinical analysis of 151 cases. Clin Exp Obstet Gynecol. 2016;43(3):379-83.
• Marquez J, Marquez JC, Arraztoa JA, Perez G, Espinoza A. [Extrapel- vic endometriosis involving the perineum]. Rev Chil Obstet Ginecol. 1995;60(1):1-4.
• Sasson IE, Taylor HS. Stem cells and the pathogenesis of endometriosis. Ann N Y Acad Sci. 2008;1127:106-15.
• Singh KK, Lessells AM, Adam DJ, Jordan C, Miles WF, Macintyre IM, ve ark. Presentation of endometriosis to general surgeons: a 10-year expe- rience. Br J Surg. 1995;82(10):1349-51.
• Hensen JH, Van Breda Vriesman AC, Puylaert JB. Abdominal wall endo- metriosis: clinical presentation and imaging features with emphasis on sonography. AJR Am J Roentgenol. 2006;186(3):616-20.
• Medeiros F, Cavalcante DI, Medeiros MA, Eleuterio J, Jr. Fine-needle aspi- ration cytology of scar endometriosis: study of seven cases and literature review. Diagn Cytopathol. 2011;39(1):18-21.
• Vellido-Cotelo R, Munoz-Gonzalez JL, Oliver-Perez MR, de la Hera-Lazaro C, Almansa-Gonzalez C, Perez-Sagaseta C, ve ark. Endometriosis node in gynaecologic scars: a study of 17 patients and the diagnostic considera- tions in clinical experience in tertiary care center. BMC Womens Health. 2015;15:13.
• Ucar MG, Sanlikan F, Gocmen A. Surgical Treatment of Scar Endomet- riosis Following Cesarean Section, a Series of 12 Cases. Indian J Surg. 2015;77(Suppl 2):682-6.
• Yela DA, Trigo L, Benetti-Pinto CL. Evaluation of cases of abdominal wall endometriosis at Universidade Estadual de Campinas in a period of 10 years. Rev Bras Ginecol Obstet 2017;39:403-407.