CoChat
Sign Up
Cited by 9Endometriosis Research and TreatmentGynecological conditions and treatmentsEndometrial and Cervical Cancer Treatments

Abdominal Wall Endometriosis: Experience of the General Surgery Service of the Antônio Pedro University Hospital of the Universidade Federal Fluminense

Open access
COSTA, JORGE EDUARDO FARIA ROCHA, ACCETTA, ITALO, MAIA, FRANCISCO JOSÉ SANTOS, SÁ, RENATO AUGUSTO MOREIRA DE·2020·Revista do Colégio Brasileiro de Cirurgiões
DOI 10.1590/0100-6991e-20202544
Open this paper in CoChat — free accountOpen PDF

Abstract

ABSTRACT Objective: to study the characteristics of women undergoing abdominal surgery with suspected abdominal wall endometriosis or abdominal wall tumor, and to assess the association with age, race and previous cesarean delivery. Method: retrospective and analytical study carried out from January 2000 to December 2019, at the General Surgery Service of Hospital Universitário Antônio Pedro (HUAP) at Universidade Federal Fluminense (UFF). Medical records of 100 patients with abdominal wall endometriosis and other types of abdominal wall tumors were analyzed. Age, color, previous history of cesarean section or abdominal surgery and histopathological data were verified. The patients were classified as young adults (aged between 18 and 28 years and 11 months) and adults. The SPSS program was used for data analysis, Fisher’s test with a significance level of 0.05. Results: abdominal wall endometriosis with histopathological confirmation was found in 22%, the mean age was 52.28 ± 18.66 which was lower when compared to other diagnoses. There was an association between previous cesarean section and abdominal wall endometriosis (p <0.005). Conclusion: the women with a diagnosis of abdominal wall endometriosis had undergone previous cesareans (the majority) and were in an active reproductive age. Although the brown skin women were the most frequent, there was no statistical difference.

AI snapshot

Written from the paper’s full text.

TL;DR

This retrospective single-center study reviewed 100 women with suspected abdominal wall endometriosis or other abdominal wall tumors and found histopathologically confirmed endometriosis in 22%. Prior cesarean section was significantly associated with abdominal wall endometriosis, while age group and skin color were not.

Key findings

  • Among 100 patients, 22 (22%) had histopathologically confirmed abdominal wall endometriosis; 21 of these 22 (95.5%) had a previous cesarean section, and 1 had no previous operation.
  • Women with endometriosis were younger than those without it (33.23 ± 4.46 years vs 57.65 ± 17.59 years, p = 0.0001), but the highest frequency was in the adult group rather than the young-adult group (17 adults vs 5 young adults; p = 0.130).
  • Previous cesarean section was associated with endometriosis (21 vs 24 without prior cesarean; 1 vs 54 with no prior cesarean; p = 0.0001), whereas color showed no significant association (white 9 vs 20; brown 12 vs 41; black 1 vs 5; p = 0.143).
  • All endometriosis cases underwent wide excision; 6 required polypropylene mesh, and postoperative evolution was satisfactory with no recurrence or complication reported.

Methods

  • Retrospective, analytical/descriptive quantitative study at the General Surgery Service of Hospital Universitário Antônio Pedro/UFF, Brazil, from January 2000 to December 2019.
  • Medical records of 100 female patients with abdominal wall endometriosis or other abdominal wall tumors were reviewed; variables included age, color, previous cesarean section or abdominal surgery, and histopathological confirmation. Patients were classified as young adults (18–28 years and 11 months) or adults (over 29 years).
  • Data were analyzed with IBM SPSS version 20.0; normality was assessed by Kolmogorov-Smirnov, age comparisons used Student’s t-test or Mann-Whitney test, and associations used Fisher’s exact test with p < 0.05.

Limitations

  • The paper states that more detailed studies are needed on the number of children and cesarean sections and their influence on tumor size, and that associations with previous laparotomy, hysterectomy, and nutritional status need better elucidation.
  • Evident from the text: this is a retrospective, single-center study with a convenience sample of 100 patients and no sample size calculation; only 22 patients had endometriosis, limiting subgroup comparisons.
  • Evident from the text: the abstract reports a mean age of 52.28 ± 18.66 years, while the results and discussion report 33.23 years for endometriosis, an internal inconsistency in the reported data.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1590/0100-6991e-20202544

Cites

45 of 45 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 24 cited sources checked · 0 supported · 0 flagged

  • Findingown data
    § DATA ANALYSIS

    Histopathological examination confirmed the preoperative diagnostic impression of endometriosis in all cases.

    “the histopathological examination of the specimens confirmed the preoperative diagnostic impression of endometriosis in all cases.”
    Quote in the paperNot a substantial claim
  • Findingown data
    § DATA ANALYSIS

    Analysis of endometriosis according to age showed no significant difference.

    “However, analysis of endometriosis according to age showed no significant difference.”
    • Also stated in: § DISCUSSION · plain
      “we found no association between abdominal wall endometriosis and the age group of young adults”
    Quote in the paperNot a substantial claim
  • Findingown data
    § DATA ANALYSIS

    The mean age of patients with abdominal wall endometriosis was 33.23 years (range 26-40).

    “The age ranged between 26 and 40 years (mean 33.23)”
    • Also stated in: § DISCUSSION · plain
      “The average age of individuals diagnosed with abdominal wall endometriosis was 33.23 years”
    Quote in the paperNot a substantial claim
  • Findingown data
    § DATA ANALYSIS

    Women with abdominal wall endometriosis had a lower mean age than women with other abdominal wall diagnoses.

    “We found that women with abdominal wall endometriosis have a lower average age”
    • Also stated in: § DISCUSSION · plain
      “patients with abdominal wall endometriosis had lower age compared with the ones with other diagnoses”
    Quote in the paperNot a substantial claim
  • Findingown data
    § DATA ANALYSIS

    All tumors were located near the cesarean section surgical scar.

    “All were located near the cesarean section surgical scar.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 12
  • Classified as probably not a substantial claim. 10

  • May combine two claims.

    Findingown data
    § DATA ANALYSIS

    The average duration of signs and symptoms was 2.66 years, ranging from 6 months to 7 years.

    “Regarding the duration of signs and symptoms, the average was 2.66 years, ranging from 6 months to 7 years.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data
    § Abstract

    Brown skin women were the most frequent among women with abdominal wall endometriosis.

    “Although the brown skin women were the most frequent”
    • Also stated in: § DISCUSSION · plain
      “Although the majority of women are brown”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data
    § DATA ANALYSIS

    In six cases, a polypropylene mesh was necessary for abdominal wall reconstruction.

    “In six cases, a polypropylene mesh was necessary to the reconstruction of the abdominal wall”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data
    § DATA ANALYSIS

    In three cases, the tumor was located in the umbilical region.

    “In three cases, it was located in the umbilical region.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Abstract

    The abstract reports a mean age of 52.28 ± 18.66 years, lower than other diagnoses.

    “the mean age was 52.28 ± 18.66 which was lower when compared to other diagnoses.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data
    § DATA ANALYSIS

    In all cases, extensive excision of the tumor and adjacent affected tissues was performed.

    “In all cases, there was extensive excision of the tumor and adjacent affected tissues (Figure 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § DATA ANALYSIS

    All tumors had imprecise limits, smooth consistency, and increased sensitivity at palpation.

    “All had, at palpation, imprecise limits, smooth consistency, and increased sensitivity.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § DATA ANALYSIS

    Postoperative evolution was satisfactory and effective, with no recurrence or complication, and improvement in pain, discomfort and tumor.

    “After the follow-up until the outpatient discharge, the postoperative evolution of the patients was satisfactory and effective, with no recurrence or complication, in addition to improvement in pain, discomfort and tumor.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data
    § DATA ANALYSIS

    The tumor was located in the left flank in one patient.

    “The tumor was located in the iliac fossa in 18 patients (eight on the right and 10 on the left), and in the left flank in one.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § DATA ANALYSIS

    The main complaint in all cases was a tumor on the abdominal wall that increased in volume and became more painful with the beginning of the menstrual period.

    “The main complaint in all cases was a tumor on the abdominal wall that increased in volume and became more painful with the beginning of the menstrual period.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data
    § RESULTS

    The majority of women in the study were adults (81.8%).

    “the majority being adults (81.8%)”
    • Also stated in: § DISCUSSION · plain
      “there were more adult women (88%)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § RESULTS

    In the studied patients, there was a higher prevalence of mixed races (54.5%) and previous cesarean sections (95.5%).

    “In addition, there was a higher prevalence of mixed races (54.5%) and of previous cesarean sections (95.5%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § DISCUSSION

    There was only one case in the present series with history of vaginal delivery, hence no previous operation.

    “There was only one case in the present series with history of vaginal delivery, hence no previous operation.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § INTRODUCTION

    Abdominal wall endometriosis generally affects women in the reproductive age group, with maximum incidence in the third and fourth decades.

    “Endometriosis usually affects women in the reproductive age group, with a maximum incidence in the third and fourth decades 5 .”
    • Also stated in: § DISCUSSION · plain
      “abdominal wall endometriosis generally affects women in the reproductive age group, with maximum incidence in the third and fourth decades 5,32 .”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [5] Wolf Y, 1996, Endometriosis in abdominal scars a diagnostic pitfall, Am Surg

      Not checked in the free run.

    • cites [32] Malutan AM, 2017, Surgical scar endometriosis a series of 14 patients and brief review of literature, Clujul Med

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § INTRODUCTION

    The treatment of abdominal wall endometriosis is essentially surgical and aims at complete resection of the tumor.

    “The treatment of abdominal wall endometriosis is essentially surgical and its main objective is the complete resection of the tumor”
    • Also stated in: § Horton et al. (2008) · plain
      “The treatment of endometriosis of the abdominal wall is essentially surgical and its main objective is complete resection”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [8] Accetta I, 2011, Endometrioma de parede abdominal, Arq Bras Cir Dig source

      Not checked in the free run.

    • cites [23] Huber M, 2019, Recognizing abdominal wall endometriosis, JAAPA source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation
    § INTRODUCTION

    The excision for abdominal wall endometriosis must be wide to remove all potentially involved skin, subcutaneous tissue, muscles, aponeuroses and peritoneum.

    “the excision must be wide to remove all skin segments, subcutaneous tissue, muscles, aponeuroses and peritoneum potentially involved 2,[24][25][26][27]”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [2] Koger KE, 1993, Surgical scar endometrioma, Surg Gynecol Obstet

      Not checked in the free run.

    • cites [24] Chun JT, 1990, Endometriosis of the abdominal wall, South Med J source

      Not checked in the free run.

    • cites [25] Patterson GK, 1999, Abdominal wall endometriomas report of eight cases, Am Surg source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § DISCUSSION

    The association between previous cesarean section and abdominal wall endometriosis is well described in the literature, since endometrial tissue can be transported to the scar or adjacent tissues during surgery.

    “This factor is well described in the literature, since endometrial tissue can be transported to the scar or adjacent tissues during surgery 12,[33][34][35][36][37][38][39][40][41][42][43] .”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [12] Zhang P, 2019, Cesarean scar endometriosis presentation of 198 cases and literature review, BMC Womens Health source

      Not checked in the free run.

    • cites [33] Khamechian T, 2014, 5-Year data analysis of patients following abdominal wall endometrioma surgery, BMC Womens Health source

      Not checked in the free run.

    • cites [34] Khan Z, 2017, Risk factors, clinical presentation, and outcomes for abdominal wall endometriosis, J Minim Invasive Gynecol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § INTRODUCTION

    When extended excision creates a defect, it should be corrected with abdominal muscles and aponeuroses when possible; if tension, a polypropylene prosthesis is most used.

    “The literature recommends that the defect created by the extended excision be corrected with the abdominal muscles and aponeuroses, when possible.However, when this implies some tension in the suture lines, the most used option is a polypropylene prosthesis 8,28 .”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [8] Accetta I, 2011, Endometrioma de parede abdominal, Arq Bras Cir Dig source

      Not checked in the free run.

    • cites [28] Pas K, 2017, Prospective study concerning 71 cases of caesarean scar endometriosis (CSE), J Obstet Gynaecol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given
    § RESULTS

    The sample size was defined by convenience, with no calculation.

    “We defined the sample size by convenience, therefore using no calculation for it.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation
    § DISCUSSION

    The age of 33.23 years represents the stage in which the woman is reproductively active.

    “This age represents the stage in which the woman is reproductively active, initially described by Chun, Nelson and Maull (1990) 24 and also found in more recent studies 12,35,38 .”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [24] Chun JT, 1990, Endometriosis of the abdominal wall, South Med J source

      Not checked in the free run.

    • cites [12] Zhang P, 2019, Cesarean scar endometriosis presentation of 198 cases and literature review, BMC Womens Health source

      Not checked in the free run.

    • cites [35] Yela DA, 2017, Evaluation of cases of abdominal wall endometriosis at Universidade Estadual de Campinas in a period of 10 Years, Rev Bras Ginecol Obstet source

      Not checked in the free run.

20 of 20

  • The paper relies on this without support.

    There is no safe clinical marker for abdominal wall endometriosis.

    “In this sense, as there is no safe clinical marker, the diagnosis occurs through histopathological analysis of a sample collected from an invasive procedure.”

  • The paper relies on this without support.

    The diagnosis of abdominal wall endometriosis occurs through histopathological analysis of a sample collected from an invasive procedure.

    “In this sense, as there is no safe clinical marker, the diagnosis occurs through histopathological analysis of a sample collected from an invasive procedure.”

  • The paper relies on this without support.

    There are no studies in the literature addressing the association between color and abdominal wall endometriosis.

    “There are no studies in the literature addressing this issue.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Surgery remains the only curative treatment for AWE, including endometriosis secondary to CS, with mass removal effectively resolving chronic pain.

    “Therefore, surgery remains the only curative treatment for AWE, including endometriosis secondary to CS, with mass removal effectively resolving chronic pain [22,27].”

    From Surgical Reconstruction of Abdominal Wall Endometriosis Post-Cesarean Section: A Monocentric Experience of a Rare Pathology (2025) · cites this paper as [22]

    The treatment discussion (indexed under “Horton et al. (2008)”; page unavailable) says AWE treatment is essentially surgical and aims at complete resection. The Data Analysis section (page unavailable) reports no recurrence during follow-up and improvement in pain after excision, including in a series where most patients had a prior cesarean section. It does not establish that surgery is the only curative treatment or that chronic pain was fully resolved. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Abdominal wall endometriosis (AWE) is among the rarest forms of primary endometriosis.

    “Abdominal wall endometriosis (AWE) is among the rarest forms of primary endometriosis [20,21,22], accounting for 20% of cases, while most are secondary to obstetric and gynecological surgeries, including laparotomic, laparoscopic, or robotic procedures.”

    From Surgical Reconstruction of Abdominal Wall Endometriosis Post-Cesarean Section: A Monocentric Experience of a Rare Pathology (2025) · cites this paper as [22]

    The Introduction calls abdominal wall endometriosis rare and says it occurs most often near a surgical scar, particularly after cesarean section. It does not rank AWE among the rarest forms of primary endometriosis or support the citing sentence’s 20% figure or reference to robotic procedures. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Diagnosis of CSE should be suspected in all women of reproductive age, especially with a history of cesarean surgery, even without evident history of endometriosis.

    “The diagnosis should be suspected even when there is no evident history of endometriosis in all women of reproductive age, especially with a history of cesarean surgery [18].”

    From Cesarean Section: A Potential and Forgotten Risk for Abdominal Wall Endometriosis (2021) · cites this paper as [18]

    The Discussion (page not provided) says abdominal wall endometriosis generally affects women of reproductive age and reports that 21 of 22 patients with the condition had a prior cesarean section. The cited copy does not address whether diagnosis should be suspected without an evident history of endometriosis, so that qualification is unsupported. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Horton review case count differs from its reference

    Minor

    The discussion describes the Horton review as containing 455 cases, while the cited article's title says 445 cases.

  • Abstract assigns the overall mean age to the endometriosis group

    Minor

    The abstract gives 52.28 years as the mean age for patients with abdominal wall endometriosis, but the reported comparison gives that group a mean age of 33.23 years. The two values describe different groups.

  • Symptom duration exceeds the stated maximum

    Minor

    The text says symptoms lasted at most seven years, but case 10 in Table 2 has a symptom duration of 7.5 years.

3 of 3

Cites

Flagged first, then by citations

3 of the 48 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

  1. Thylan S, 1996, Abominal wall endometrioma in a laparoscopic trocar tract, A case report [comment]. Am Surg, 62, 617
  2. Koninckx PR, 2018, Risk factors, clinical presentation, and outcomes for abdominal wall endometriosis [comment] J Minim Invasive, Gynecol, 25, 342
  3. Satyanarayana MA, 2018, Endometriosis A Clinicopathological Study of 29 Cases, J Clin Diagn Res, 12, EC05
  4. Ramos-Mayo AE, 2019, Experience of the hernia and wall department in the management of abdominal wall endometriosis for 9 years, Cir Cir, 87, 385
  5. Grigore M, 2017, Abdominal wall endometriosis an update in clinical, imagistic features, and management options, Med Ultrason, 19, 430, 10.11152/mu-1248 · DOI · Paper page

Cited by

Sorted by citations

Related

Authors
COSTA, J. E. F. R., ACCETTA, I., MAIA, F. J. S., & SÁ, R. A. M. D.
Affiliations
Universidade Federal Fluminense (BR)
ORCID
Venue
Revista do Colégio Brasileiro de Cirurgiões
Publisher
FapUNIFESP (SciELO)
Published
2020
Volume
47
Pages
e20202544-e20202544
ISSN
  • 0100-6991 (ISSN-L)
  • 1809-4546
DOI
10.1590/0100-6991e-20202544
OpenAlex
W3088986385
Semantic Scholar
ecfa5c2c25a310e451754d90d69ec036b4a2a139
Cited by
9
References
48
Citations by year
2025: 2 · 2024: 2 · 2022: 2 · 2021: 2 · 2020: 1
FWCI
1.10
Type
journal article
Language
en
Open access
Licence
Locations
  • Revista do Colégio Brasileiro de Cirurgiões (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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 › Endometrial and Cervical Cancer Treatments
Keywords
abdominal wall endometriosis, abdominal wall tumor, cesarean section, previous abdominal surgery, skin color, histopathological confirmation, reproductive age
MeSH terms
Adult, Aged, Cesarean Section, Endometriosis, Female, Hospitals, University, Humans, Middle Aged, Postoperative Complications, Pregnancy, Retrospective Studies, Abdominal Wall, Young Adult

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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

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 ›

Are you an author, or do you see a problem with this page? Request a review