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Cited by 49Endometriosis Research and TreatmentIntestinal and Peritoneal AdhesionsGynecological conditions and treatments

Abdominal Wall Endometriosis: An Overlooked but Possibly Preventable Complication

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Teng, Chen-Chih, Yang, Han-Ming, Chen, Kuang-Fa, Yang, Chi-Jui, Chen, Lien-Sheng, Kuo, Chuen-Long·2008·Taiwanese Journal of Obstetrics and Gynecology
DOI 10.1016/s1028-4559(08)60053-4
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Abstract

OBJECTIVE: To find ways of preventing abdominal wall endometriosis through a retrospective case review. MATERIALS AND METHODS: A retrospective study of 22 patients presenting with 26 postoperative abdominal wall masses. All masses were pathologically proved to be scar endometriosis between September 1994 and September 2006. The age, parity, symptoms and duration, previous surgeries, interval between previous surgery and current operation, initial diagnosis, and the 26 sites and size of endometrioma were recorded and analyzed. RESULTS: About 60% of the patients were in the fourth decade of life. All 22 cases, except one with mid-trimester hysterotomy, had previous cesarean section (CS). Three cases had vertical midline incision for CS, and the other 19 had Pfannenstiel incision, 18 of which were for CS and one for hysterotomy. Of the 22 cases, only three had multiple endometriomas, i.e. one case had three foci and the other two cases had two foci each. Twenty-three endometriomas were found in the Pfannenstiel incision group; 19 out of the 23 foci (82%) were located in either corner of the Pfannenstiel incision wounds (with right side predominance in 13 out of 19). Three endometriomas were noted in vertical midline incisions and two were in the upper corner. Three endometrioma excisions were done during repeated CS. CONCLUSION: Abdominal wall endometriosis may be caused by iatrogenic inoculation of the endometrium into the surgical wound. It is strongly recommended that, at the conclusion of the surgical procedure, the abdominal wound be cleaned thoroughly, particularly at both corner sites (especially the operators side). If an abdominal wall endometriosis is encountered after CS but the patient plans to have future pregnancy and the symptoms are mild, excision of the endometrioma may be deferred until the next indicated CS.

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Crossref · 10.1016/s1028-4559(08)60053-4

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  • Teng et al. reported that endometriosis in a Pfannenstiel incision scar was found more often at the right corner of the surgery scar (68%), possibly because of the predominance of operators standing on their patient's right side during surgery and endometrial inoculums not being easily found and removed on that side.

    “They reported that endometriosis in a Pfannenstiel incision scar was found more often at the right corner of the surgery scar (68%), possibly because of the predominance of operators standing on their patient’s right side during surgery and endometrial inoculums not being easily found and removed on that side.”

    From Appearance of abdominal wall endometriosis on MR imaging (2010) · cites this paper as [27]

  • We found no evidence of a predilection for scar endometriosis at the right or left corner, as previously reported by Teng et al.

    “Although it could be related to the technical aspects of surgery and, in particular, the methods of suturing, we found no evidence of a predilection for scar endometriosis at the right or left corner, as previously reported by Teng et al. [27]”

    From Appearance of abdominal wall endometriosis on MR imaging (2010) · cites this paper as [27]

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Authors
Teng, C.-C., Yang, H.-M., Chen, K.-F., Yang, C.-J., Chen, L.-S., & Kuo, C.-L.
Affiliations
Chang Bing Show Chwan Memorial Hospital (TW)
Venue
Taiwanese Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2008-03
Volume
47
Issue
1
Pages
42-48
ISSN
1028-4559 (ISSN-L)
DOI
10.1016/s1028-4559(08)60053-4
OpenAlex
W2102355347
Cited by
49
References
28
Citations by year
2026: 1 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 1 · 2019: 4 · 2018: 3 · 2017: 3 · 2016: 4 · 2015: 1 · 2014: 2 · 2013: 4 · 2012: 4
FWCI
3.48
Type
journal article
Language
en
Open access
Licence
Locations
  • Taiwanese Journal of Obstetrics and Gynecology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
Keywords
abdominal wall endometriosis, scar endometriosis, cesarean section, Pfannenstiel incision, hysterotomy, endometrioma excision
MeSH terms
Adult, Cesarean Section, Cicatrix, Endometriosis, Female, Humans, Postoperative Complications, Pregnancy, Retrospective Studies, Wound Healing, Abdominal Wall

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