Abdominal Wall Endometrioma: A Case Report and Review of the Literature

Abstract 

Endometriosis is the presence of ectopic endometrial tissue that can respond to ovarian hormonal stimulation. Although it is uncommon, extrapelvic endometriosis can form a discrete mass known as an abdominal wall endometrioma. Endometriomas are thought to be caused by transfer of endometrial cells into a surgical wound, most often after a cesarean delivery. Endometriomas are diagnosed via ultrasound, computed tomography, magnetic resonance imaging, and ultrasound-guided fine needle aspiration. Treatment options can be medical, but surgical excision is the treatment of choice. Perioperative nursing care includes patient teaching, taking steps to prevent surgical site infection and inadvertent hypothermia, ensuring availability of supplies (eg, the graft for abdominal wall repair if needed), and postoperative pain management.

Key words: endometriosis, endometrioma, rectus abdominus, abdominal wall mass

• 1 3M™ Steri-Drape™ wound edge protector. 3M. http://solutions.3m.com/wps/portal/3M/en_NZ/Littmann/stethoscope/products/product-catalogue/?PC_7_RJH9U5230GE3E02LECIE20KF62_nid=PTDM8B1RG4beBNT7BTDDS8gl. Accessed February 27, 2010.
• 2 Bachir JS, Bachir N. Scar endometrioma: awareness and prevention. Wisconsin Med J. 2002;101(1):46-50.
• 3 Minaglia S, Mishell DR Jr, Ballard C. Incisional endometriomas after Cesarean section: a case series. J Reprod Med. 2007;52(7):630-634. http://www.reproductivemedicine.com/toc/auto_abstract.php?id=23046. Accessed March 1, 2010.
• 4 Teng CC, Yang HM, Chen KF, Yang CJ, Chen LS, Kuo CL. Abdominal wall endometrioma: an overlooked but possibly preventable complication. Taiwan J Obstet Gynecol. 2008;47(1):42-48.
• 5 Gunes M, Kayikcioglu F, Ozturkoglu E, Haberal A. Incisional endometriosis after cesarean section, episiotomy and other gynecologic procedures. J Obstet Gynaecol Res. 2005;31(5):471-475.
• 6 Toullalan O, Baqué P, Benchimol D, et al. Endometriosis of the rectus abdominis muscles [in French]. Ann Chir. 2000;125(9):880-883.
• 7 Wasfie T, Gomez E, Seon S, Zado B. Abdominal wall endometrioma after cesarean section: a preventable complication. Int Surg. 2002;87(3):175-177.
• 8 Wheeler CB, Rodeheaver GT, Thacker JG, et al. Side-effects of high pressure irrigation. Surg Gynecol Obstet. 1976;143:775-778.