Clinical Analysis Of 35 Patients With Abdomimal Wall Endometriosis

Objective:To summarize the clinical characteristics of patients who suffered from abdominal wall endometriosis, and to explore the mechanism,diagnosis,treatment,prophylaxis.Methods: Review the clinical information of 35 inpatients that suffered from abdominal wall endometriosis and received surgical operation from January 2000 to October 2010 in the first affiliated hospital of Guangxi Medical University.Results: All patients had a history of cesarean section. The presenting symptoms were abdominal mass,85.7% presented with painful abdominal mass,74.3% presented with cyclic presenting symptom associated with menstruation .26 patients had tested serum cancer antigen (CA)‐125 ,CA125 exceed 35U/L in 8 patients , the mean level of CA125 was 30.9U/L (range ,5.65‐10.43U/L) . 35 patients had ultrasonographic examination, 2 had computed tomography (CT) scan before operation. 3 patients had medical treatment preoperatively, and one of them was a recurrence case who had received the fist abdominal wall endometriosis surgeon in other hospital. 35 patients treated with excision of the lesion. About the surgical excision, 31 patients included 0.5‐1cm of surrounding healthy tissue, 4 patients include 3‐4cm of surrounding healthy tissue. Because of excision part of peritoneum, we had pelvic exploration in 12 patients at the time of surgery, 2 patients had evidence of concomitant pelvic endometriosis and received medical treatment postoperatively. 6 patients required prolead patch grafting for the resulting fascia defect which was >6cm.Conclusion: 1,Abdominal wall endometriosis is usually secondary to cesarean section 2,The classic presenting symptom was abdominal mass and cyclic presenting symptom associated with menstruation . 3,Serum CA125 is seldom high and is not useful for the diagnosis . 4,Iconographical appearance of abdominal wall endometriosis is nonspecific . 5,Wide excision is considered the first treatment of choice with at least 0.5‐1cm surrounding healthy tissue , it is necessary to use patch grafting for the resulting fiscal defect which is >6cm.