The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.
Endometriosis of Abdominal and Pelvic Wall Scars: Multimodality Imaging Findings, Pathologic Correlation, and Radiologic Mimics
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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In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“On MRI, the presence of blood components within the abdominal wall mass is suggestive of endometriosis.”
From Extra-pelvic endometriosis: a review. (2020) · cites this paper as [21]
In the citing paper
“MRI and CT are helpful for clarifying the extent of the lesion, fascia involvement, and the depth of lesion invasion.”
From Extra-pelvic endometriosis: a review. (2020) · cites this paper as [21]
In the citing paper
“The development of endometriosis after surgical operation is most likely attributed to the spread of endometrial tissue into the surgical wound [5].”
From Giant Abdominal Wall Endometrioma: A Case Report (2021) · cites this paper as [5]
In the citing paper
“Abdominal wall endometrioma typically develops after surgical procedures on the uterus, such as cesarean section.”
From Giant Abdominal Wall Endometrioma: A Case Report (2021) · cites this paper as [5]
Citations
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Cited by
Sorted by citations
Items 101–121 of 121
Paolantonio, P., & Dromain, C. (2013) · A - Z notes in radiological practice and reporting/A-Z notes in radiological practice and reporting · doi:10.1007/978-88-470-5489-9_5
Abdominal wall endometriosis post C-section
Bickle, I. C. (2012) · Radiopaedia.org · doi:10.53347/rid-20338
Ultrasound Characterization of Abdominal Wall Endometriosis
Hassan, M. B. (2020) · Indian Journal of Forensic Medicine & Toxicology · doi:10.37506/ijfmt.v14i3.10543
Abdominal Incision and Injection Sites
(2015) · Elsevier eBooks · doi:10.1016/b978-0-323-37755-3.50045-3
A case series of scar endometriosis after cesarean section
Desai, S., Mistry, H. U., & Parikh, R. C. (2022) · Indian Journal of Case Reports · doi:10.32677/ijcr.v8i9.3612
Scar endometriosis: Looking beyond the diagnosis - A case series
Chandola, S., & Garg, A. (2022) · South African Journal of Radiology · doi:10.4102/sajr.v26i1.2493
Endometriosis sobre cicatriz de cesárea: presentación de un caso
Valle, J. B. D., Rendon, F. O., Ducrey, G., & del Valle-Jaén, A. (2023) · Revista Argentina de Radiología / Argentinian Journal of Radiology · doi:10.24875/rar.22000006
Normal Anatomy: Magnetic Resonance Imaging
Birkholz, J. H. (2023) · Springer eBooks · doi:10.1007/978-3-031-21336-6_8
Scar Endometriosis: A Black and White Review of a Red Giant
Tandon, A., Chandel, M., Sihag, P., Kudri, B. S., & Chowdhary, R. K. (2024) · Journal of South Asian Federation of Obstetrics and Gynaecology · doi:10.5005/jp-journals-10006-2396
Karın Duvarı Endometriozisi: Olgu Sunumu
Karatepe, Y. K. (2015) · AYDIN SAĞLIK DERGİSİ · doi:10.17932/iau.asd.2015.007/asd_v011i1006
Mandoul, C. (2025) · Springer eBooks · doi:10.1007/978-3-031-76684-8_9
Peritoneal Cavity, Vessels, Nodes, and Abdominal Wall
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Regarding “Cesarean Scar Niche and Pelvic Pain: A Systematic Review and Meta-Analysis”
Li, W., Chen, S., Wang, Y., & Ke, R. (2025) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2025.09.535
BAŞPINAR, N., Atalar, M., Aktı, S., Önal, C., & Çetin, A. (2026) · Kafkas Journal of Medical Sciences · doi:10.5505/kjms.2026.82608
Zagoria, R. J., Dyer, R., & Brady, C. (2016) · Elsevier eBooks · doi:10.1016/b978-0-323-05775-2.00007-6
US of the Postprocedure Uterus: Long-term Findings with Correlative Imaging
Horrow, M. M., & Rodgers, S. K. (2026) · Radiographics · doi:10.1148/rg.250183
Endometriosis: imaging spectrum of unusual locations and atypical presentations
Salgado-Parente, A., Lachén, E. C., Murad, V., Giménez, S. E., Sebastià, C., Paño, B., Buelga, I. F., & Campos, A. V. (2026) · Abdominal Radiology · doi:10.1007/s00261-026-05629-4
Diagnostic Value of Imaging Findings Compared with Pathology in the Diagnosis of Endometriosis
Rouzbahani, A. K., Mahmoudvand, G., Tabari, M. A. K., Cholcheh, S. N., Beiranvand, M., Shahmoradi, M. K., & Heidarian, M. (2026) · Journal of Obstetrics Gynecology and Cancer Research · doi:10.24200/jogcr.11.8.713
Dermoscopic features of cutaneous endometriosis arising in a caesarean section
Tercan, Ş. Y. S., Tercan, E., Temız, P., Tercan, C., Canbulut, M., & Bilaç, C. (2026) · Anais Brasileiros de Dermatologia · doi:10.1016/j.abd.2026.501440
Dual-site concurrent abdominal wall and lower uterine cesarean scar endometriosis: a case report
Lacsamana, J. M., Genobaga, S., & Genobaga, C. (2026) · Case Reports in Women s Health · doi:10.1016/j.crwh.2026.e00864
Implante posoperatorio de tejido endometrial en pared abdominal: ¿es un problema evitable?
Muas, D. M. J. (2024) · Revista Hispanoamericana de Hernia · doi:10.20960/rhh.00584
Metadata
- 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)
- Venue
- RadioGraphics
- Published
- 2012-11
- Volume
- 32
- Issue
- 7
- Pages
- 2031-2043
- ISSN
- 0271-5333 (ISSN-L)
- 1527-1323
- 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 › Obstetrics and Gynecology › 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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