Assistant Professor.
Associate Professor and Assistant Director of Gynecologic Minimally Invasive Surgery, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Women's Hospital of UPMC, Pittsburgh, PA.
Obstet Gynecol Surv. 2017 Feb;72(2):116-122. doi: 10.1097/OGX.0000000000000399.
Abdominal wall endometriosis (AWE) is a rare but easily treated cause of pain in women, especially those who have undergone cesarean deliveries.
This article reviews the diagnosis and management of AWE, a condition that generally develops after surgery but may arise spontaneously. We present a systematic review of the existing literature on AWE, as well as our clinical recommendations for medical and surgical management.
We searched PubMed and other databases using the search criteria "abdominal wall endometriosis," "abdominal wall endometriomas," and "abdominal wall mass." The references of those articles were then reviewed, and additional publications were evaluated.
Many case reports and case series have been published describing AWE. The overall quality of evidence is poor due to the lack of prospective studies and heterogeneous descriptions of AWE lesions and treatment options. Based on the available literature, it appears that AWE may arise spontaneously but is generally associated with prior pelvic surgery. Abdominal wall endometriosis can be diagnosed with a careful history and physical examination. Imaging including ultrasound and magnetic resonance imaging can assist with localization of the lesions, and aid in surgical excision and management. Lesions that have been removed in their entirety are unlikely to reoccur.
Although limited, the body of literature describing management of AWE suggests that it can be successfully treated in most patients with careful surgical planning.
腹壁子宫内膜异位症（AWE）是一种罕见但易治疗的女性疼痛病因，尤其是那些经历过剖宫产的女性。
本文综述了 AWE 的诊断和管理，这是一种通常在手术后发生但也可能自发出现的疾病。我们对 AWE 的现有文献进行了系统综述，并提出了我们对 AWE 的医学和手术管理的临床建议。
我们使用“腹壁子宫内膜异位症”、“腹壁子宫内膜异位瘤”和“腹壁肿块”等搜索标准在 PubMed 和其他数据库中进行了搜索。然后，我们对这些文章的参考文献进行了回顾，并对其他出版物进行了评估。
许多病例报告和病例系列已经发表，描述了 AWE。由于缺乏前瞻性研究以及 AWE 病变和治疗选择的描述存在异质性，证据总体质量较差。根据现有文献，AWE 可能自发发生，但通常与先前的盆腔手术有关。仔细的病史和体格检查可以诊断 AWE。包括超声和磁共振成像在内的影像学检查可以帮助定位病变，并有助于手术切除和管理。完整切除的病变不太可能再次出现。
尽管文献有限，但描述 AWE 管理的文献表明，大多数患者通过仔细的手术计划可以成功治疗。
