Endometriosis of the abdominal wall: ultrasonographic and Doppler characteristics
Abstract
Objectives: To describe the sonographic and clinical features of abdominal wall endometriosis (AWE), a frequently misdiagnosed condition. Methods: This was a retrospective study of 21 consecutive women with pathologically proven endometriosis of the abdominal wall. Ultrasonographic and Doppler examinations were performed, before surgery, with a high‐frequency linear transducer. The clinical data and the results of the sonographic examinations were reviewed and described. Results: At ultrasound, all the nodules appeared as discrete solid masses that were less echogenic than the surrounding hyperechoic fat. The nodules had a median diameter of 20 (range, 5–50) mm and in 18/21 (86%) cases the nodules had a round/oval shape. In eight of 21 (38%) women the AWE was located at the umbilicus, in six of 21 (29%) it was between the transverse suprapubic line and the umbilicus, in five of 21 (24%) it was found along the scar of a previous Cesarean section and in two of 21 (9%) it was in the right inguinal canal. The content was homogeneously hypoechoic in 12/21 (57%) women and inhomogeneous in the other nine (43%). The outer borders were invariably ill defined. Scarce blood vessels were found by power Doppler. Cyclic or continuous spontaneous pain at the level of the AWE was present in 19/21 (91%) cases, and two (9%) patients were asymptomatic. Conclusions: Hypoechoic round/oval nodules with ill‐defined borders and a hyperechoic rim should raise the suspicion of abdominal wall endometriosis, even in patients with no history of endometriosis or previous laparotomic surgery. Pressing the ultrasound probe against the nodule should reinforce a suspected diagnosis because of the pain it induces. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
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Sonographic studies have described abdominal wall endometriosis as solid lesions with ill-defined blurred outer borders and a hyperechoic ring corresponding to edematous adipose tissue filled with inflammatory cells.
“Interestingly, the few studies that consider the sonographic features of abdominal wall endometriosis have described specific features, including solid lesions with ill-defined blurred outer borders and the presence of a hyperechoic ring. The latter correspond to adipose tissue that has become edematous and is filled with cells of inflammatory origin (9, 10).”
From Abdominal wall endometriosis: differentiation from other masses using CT features (2017) · cites this paper as [10]
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- Authors
- Savelli, L., Manuzzi, L., Di Donato, N., Salfi, N., Trivella, G., Ceccaroni, M., & Seracchioli, R.
- Affiliations
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- Corresponding author
- Savelli, L.
- Venue
- Ultrasound in Obstetrics & Gynecology
- Publisher
- Wiley
- Published
- 2012-02-27
- Volume
- 39
- Issue
- 3
- Pages
- 336-340
- ISSN
- 0960-7692 (ISSN-L)
- 1469-0705
- OpenAlex
- W2030212359
- Semantic Scholar
- 8cd2ba73c679118088110297afaf7bb376003d73
- Cited by
- 80
- References
- 9
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 8 · 2021: 4 · 2020: 9 · 2019: 6 · 2018: 6 · 2017: 6 · 2016: 3 · 2015: 4 · 2014: 8 · 2013: 4 · 2012: 6
- FWCI
- 6.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Ultrasound in Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- abdominal wall endometriosis, sonographic features, power Doppler, hypoechoic nodules, umbilical endometriosis, cesarean section scar, cyclic pain, misdiagnosis
- MeSH terms
- Adult, Cesarean Section, Cicatrix, Endometriosis, Female, Humans, Middle Aged, Pain, Retrospective Studies, Ultrasonography, Doppler, Abdominal Wall
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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