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Cited by 121Endometriosis Research and TreatmentGynecological conditions and treatmentsEctopic Pregnancy Diagnosis and Management

Endometriosis of Abdominal and Pelvic Wall Scars: Multimodality Imaging Findings, Pathologic Correlation, and Radiologic Mimics

Gidwaney, Rita, Badler, Ruth L., Yam, Benjamin L., Hines, John J., Alexeeva, Vlada, Donovan, Virginia, Katz, Douglas S.·2012·RadioGraphics
DOI 10.1148/rg.327125024
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Abstract

Implantation of an endometriotic lesion within a pelvic or abdominal wall scar is an uncommon but well-described condition that may be the underlying cause of acute or chronic recurrent abdominal or pelvic pain, especially after cesarean section. Radiologists may not consider scar endometriosis when it is encountered at cross-sectional imaging. Cesarean section scars are the most common site of extraovarian or extrauterine endometriosis. The condition also has been identified in other uterine surgery-related scars and in the skin, subcutaneous tissues, and abdominal and pelvic wall musculature adjacent to these scars. The most plausible cause of scar endometriosis is implantation of endometrial stem cells at the surgical site at the time of uterine surgery. Patients with scar endometriosis may be asymptomatic or present with cyclical pain corresponding to the menstrual cycle. Cross-sectional imaging findings vary from the nonspecific to those suggestive of the diagnosis when combined with clinical history. In particular, the presence of blood products in an anterior abdominal wall mass at magnetic resonance (MR) imaging with no other explanation is strongly suggestive of scar endometriosis. Ultrasonography, computed tomography, and MR imaging may be used to depict an endometriotic lesion, exclude endometriosis, or provide evidence for an alternative diagnosis.

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Crossref · 10.1148/rg.327125024

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  • The existing literature on CT features of abdominal wall endometriosis is limited to case reports, with CT features often described as nonspecific with variable attenuation and enhancement characteristics.

    “While some have studied sonographic features of AWE (5,6,7,8,9,10), the existing literature on CT is limited to case reports, with CT features often described as nonspecific with variable attenuation and enhancement characteristics (4,5,7,8,11).”

    From Abdominal wall endometriosis: differentiation from other masses using CT features (2017) · cites this paper as [4]

  • Abdominal wall scar endometriosis occurs in 1%-2% of women following a cesarean section delivery.

    “Abdominal wall scar endometriosis occurs in 1%–2% of women following a cesarean section delivery.”

    From Scar endometriosis presenting as a painful abdominal mass (2020) · cites this paper as [3]

  • Preoperatively, it is challenging to differentiate endometriosis from other abdominal masses (diagnostic rate: 20%-50%).

    “Preoperatively, it is challenging to differentiate endometriosis from other abdominal masses (diagnostic rate: 20%–50%).[3]”

    From Scar endometriosis presenting as a painful abdominal mass (2020) · cites this paper as [3]

  • Scar endometriosis may appear as a hypoechoic lesion with thick echogenic strands, which often overlaps with fibrous lesions.

    “Scar endometriosis may appear as a hypoechoic lesion with thick echogenic strands, which often overlaps with fibrous lesions.[3]”

    From Scar endometriosis presenting as a painful abdominal mass (2020) · cites this paper as [3]

  • Ultrasonography, CT, and MRI are all useful for diagnostic imaging of AWE.

    “Ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) are all useful for diagnostic imaging.”

    From Extra-pelvic endometriosis: a review. (2020) · cites this paper as [21]

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Authors
Gidwaney, R., Badler, R. L., Yam, B. L., Hines, J. J., Alexeeva, V., Donovan, V., & Katz, D. S.
Affiliations
  • Winthrop-University Hospital (US)
  • Hospital of the University of Pennsylvania (US)
ORCID
Venue
RadioGraphics
Publisher
Radiological Society of North America (RSNA)
Published
2012-11
Volume
32
Issue
7
Pages
2031-2043
ISSN
  • 0271-5333 (ISSN-L)
  • 1527-1323
DOI
10.1148/rg.327125024
OpenAlex
W2168474057
Semantic Scholar
29a71db54c322bb44defb4c5390eb9f3f05f00a1
Cited by
120
References
38
Citations by year
2026: 4 · 2025: 6 · 2024: 6 · 2023: 5 · 2022: 7 · 2021: 12 · 2020: 16 · 2019: 9 · 2018: 12 · 2017: 9 · 2016: 8 · 2015: 8 · 2014: 10 · 2013: 4 · 2012: 3
FWCI
9.31
Type
journal article
Language
en
Open access
closed
Locations
  • Radiographics (publishedVersion)
  • PubMed (publishedVersion)
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
scar endometriosis, abdominal wall endometriosis, cesarean section, postoperative pain, MRI findings, ultrasonography, computed tomography, pathologic correlation
MeSH terms
Pelvic Inflammatory Disease, Adult, Cicatrix, Endometriosis, Female, Humans, Middle Aged, Radiography, Abdominal, Tomography, X-Ray Computed

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