Document Detail

Reliable clinical and sonographic findings in the diagnosis of abdominal wall endometriosis near cesarean section scar.
MedLine Citation:
PMID:  22590667     Owner:  NLM     Status:  PubMed-not-MEDLINE    
AIM: To highlight sonographic and clinical characteristics of scar endometrioma with special emphasis on size-related features.
METHODS: Thirty women (mean age 30.6 years, range 20-42 years) with 33 scar endometriomas (mean diameter 27.1 mm, range 7-60 mm) were consecutively studied by Sonography and Color Doppler examination prior to surgery. Pathological examination was available in all cases.
RESULTS: The most frequent (24 of 33 nodules, 74%) sonographic B-mode aspect of endometrioma was that of an inhomogenously hypoechoic roundish nodule with fibrotic changes (in the form of hyperechoic spots or strands), a peripheral inflammatory hyperechoic ring, spiculated margins and a single vascular pedicle entering the mass at the periphery. On average, 1.6 cesarean sections were recorded per patient (range 1-3). The median interval between the last cesarean section and admission to hospital was 36 mo (range 12-120 mo) and the median duration of symptoms before admission was 25.7 mo (range 0.5-80 mo). 13 patients had 13 large endometriomas (≥ 30 mm) with a mean lesion diameter of 41.3 ± 9.02 mm (range 30-60 mm). Seventeen women had 20 small endometriomas with a mean lesion size of 18.2 ± 5.17 mm (range 7-26 mm). The mean interval between the last cesarean section and admission to hospital (66.0 mo vs 39.6 mo, P < 0.01) and the mean duration of symptoms before admission (43.0 mo vs 17.4 mo, P < 0.01) were significantly longer in patients with large endometriomas; in addition, a statistically significant higher percentage of patients with large implants had undergone previous inconclusive diagnostic examinations, including either computed tomography/magnetic resonance imaging/fine needle biopsy/laparoscopy (38.4% vs 0%, P < 0.05). On sonography, large endometriomas showed frequent cystic portions and fistulous tracts (P < 0.02), loss of round/oval shape (P < 0.04) along with increased vascularity (P < 0.04).
CONCLUSION: Endometrioma near cesarean section scar is an often neglected disease, but knowledge of its clinical and sonographic findings may prevent a delay in diagnosis that typically occurs in patients with larger (≥ 3 cm) endometriomas.
Giampiero Francica
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of radiology     Volume:  4     ISSN:  1949-8470     ISO Abbreviation:  World J Radiol     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-05-16     Completed Date:  2012-10-02     Revised Date:  2014-05-15    
Medline Journal Info:
Nlm Unique ID:  101538184     Medline TA:  World J Radiol     Country:  China    
Other Details:
Languages:  eng     Pagination:  135-40     Citation Subset:  -    
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