This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Francica, G. Articles by Tramontano, G. Search for Related Content PubMed PubMed Citation Articles by Francica, G. Articles by Tramontano, G.

Abdominal Wall Endometriomas Near Cesarean Delivery Scars

Sonographic and Color Doppler Findings in a Series of 12 Patients

Servizio di Ecografia ed Ecointerventistica (G.F.) and Dipartimento di Chirurgia Generale (C.G., G.A., S.C., R.F., G.T.), Presidio Sanitario Camilliani S. Maria della Pietà, Casoria, Italy.

Address correspondence and reprint requests to Giampiero Francica, MD, Servizio di Ecografia ed Ecointerventistica, Presidio Sanitario Camilliani S. Maria della Pietà, Via S. Rocco 9, 80026 Casoria, Italy. E-mail: giampierofrancica{at}tin.it.

Purpose. To describe the sonographic and color Doppler features of endometriomas of the abdominal wall arising near cesarean delivery scars. Methods. Twelve women (mean age, 31 years; range, 22–42 years) underwent sonographic and color Doppler examination of the abdominal wall with high-frequency probes for the presence of painful nodules near cesarean delivery scars, cyclic or continuous lower abdominal pain, or both. Results. All patients had undergone at least 1 cesarean delivery before admission (mean, 4.1 years; range, 2–12 years). A typical clinical presentation (ie, mass and cyclic pain and swelling during menses) was recorded in 6 cases. Sonography disclosed all subcutaneous nodules (mean size, 28.1 mm; range, 7–50 mm). Common sonographic features included (1) a hypoechoic inhomogeneous echo texture with internal scattered hyperechoic echoes; (2) irregular margins, often spiculated, infiltrating the adjacent tissues; and (3) a hyperechoic ring of variable width and continuity. At color Doppler examination, a single vascular pedicle entering the mass at the periphery was shown in 7 cases. Abundant intralesional vascularization was shown in 3 cases with diameters of greater than 3 cm, whereas no vascular sign could be detected in 2 lesions smaller than 15 mm. All patients underwent wide surgical excision, and pathologic examination disclosed endometrial tissue in all of them. No relapses were recorded at clinical and sonographic follow-up (4–23 months). Conclusions. Sonographic and color Doppler findings, when properly combined with clinical data, may substantially contribute to the correct preoperative diagnosis of abdominal wall endometriomas.

Key Words: abdominal wall • cesarean delivery • color Doppler sonography • endometriosis • sonography

Abbreviations: RI, resistive index

This article has been cited by other articles:

				S. Gokhale Sonography in identification of abdominal wall lesions presenting as palpable masses. J. Ultrasound Med., September 1, 2006; 25(9): 1199 - 1209. [Abstract] [Full Text] [PDF]

				G. Francica Sonographic features of abdominal wall endometrioma. Am. J. Roentgenol., July 1, 2006; 187(1): W127 - W127. [Full Text] [PDF]

				J.-H. J. Hensen, A. C. Van Breda Vriesman, and J. B. C. M. Puylaert Abdominal wall endometriosis: clinical presentation and imaging features with emphasis on sonography. Am. J. Roentgenol., March 1, 2006; 186(3): 616 - 620. [Abstract] [Full Text] [PDF]

				E. Kuligowska, L. Deeds III, and K. Lu III Pelvic Pain: Overlooked and Underdiagnosed Gynecologic Conditions RadioGraphics, January 1, 2005; 25(1): 3 - 20. [Abstract] [Full Text] [PDF]