Clinical Analysis Of 55 Cases Of Abdominal Wall Endometriosis

Background:Abdominal wall endometriosis (AWE) is defined as the presence of functioning endometrial glands and stroma in the subcutaneous fatty tissue and the abdominal wall muscle layers. Abdominal wall endometriosis (AWE) is usually found in women with prior gynecologic, obstetric or non-gynecologic surgery and has been noticed particularly after Cesarean section.Aims:The aim of this thesis was to study the patient characteristics, clinical manifestations and preoperative diagnostic methods for excised cases of abdominal wall endometriosis.Method:Retrospective analysis of clinical characteristics of 55 cases of pathologically confirmed and surgically excised cases of AWE over a period of 2 years, from October 2012 to September 2014, at The First Affiliated Hospital of Kunming Medical University, Kunming, China, were included. The age, parity, weight, height, symptoms, previous surgeries, diagnostic imaging techniques and histopathological evaluation were noted and analyzed. The results were analyzed using SPSS 22.Results:There were 55 patients with a mean age of 31.9±4.2 years. All the patients were multiparous and the number of parities ranged from one to three. The majority of the patients had normal weight (69%). All (100%) of patients had a history of cesarean section. All (100%) had symptoms of abdominal mass sensation in or adjacent to the cesarean section scar site. This was often associated with abdominal pain (54.5%). The mean duration of symptoms was 33.2±27.08 months and the mean asymptomatic period was 34.1±23.56 months. The symptomatic period for AWE patients with age>30years (37 cases) was longer than the ones with age≤30years (11 cases), whose differences is statistically significant (P<0.05). Similarly the patients age didn’t have any influence on the asymptomatic period (P>0.05).The differences of patients age≤30 years (44cases) and>30years (11cases) at the time of cesarean section influencing the asymptomatic period, is statistically insignificant (P>0.05). Abdominal and pelvic ultrasound was the most frequently used diagnostic methods. The mean diameter of the mass at presentation was 2.69±1.22 cm.Conclusion:Cesarean section is usually associated with the development of abdominal wall endometriosis. The rate of cesarean section is increasing, thus the measures to control the increasing number of cesarean section should be sorted. AWE should be suspected in symptomatic women with a history of gynecologic or non-gynecologic surgery mainly cesarean section. Also, it is very important to focus on the proper diagnosis and prompt management of this condition.