Chen Li-Yung, Hsu Sheng-Der
Department of Surgery, Gangshan Branch, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
Department of Surgery, Song Shan Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Gynecol Minim Invasive Ther. 2020 Apr 28;9(2):98-100. doi: 10.4103/GMIT.GMIT_74_18. eCollection 2020 Apr-Jun.
Abdominal wall scar endometriosis occurs in 1%-2% of women following a cesarean section delivery. We report a case of a 36-year-old woman with scar endometriosis, presenting with an acute, painful abdominal wall mass. She underwent a cesarean section 8 years before presentation. She was admitted to the emergency room for physical examination of the abdomen, which revealed a palpable mass. Abdominal computed tomography (CT) revealed an ill-defined soft-tissue lesion over the left rectus abdominis muscle (abdominal scar). Surgical removal of the abdominal wall mass was performed with adequate clearance margins with a preoperative diagnosis of postcesarean scar endometriosis. Postcesarean scar endometriosis is a rare cause of an abdominal mass; however, when this condition presents acutely, it can be difficult to diagnose. In this case, careful analysis of the patient's history, CT images, and histopathological results together confirmed the diagnosis. Surgical excision was performed under general anesthesia while maintaining adequate clearance margins.
腹壁瘢痕子宫内膜异位症在剖宫产术后女性中的发生率为1%-2%。我们报告一例36岁患有瘢痕子宫内膜异位症的女性病例,表现为急性疼痛性腹壁肿块。她在就诊前8年接受了剖宫产。她因腹部体格检查被收入急诊室,检查发现可触及肿块。腹部计算机断层扫描(CT)显示左腹直肌(腹部瘢痕)上方有边界不清的软组织病变。术前诊断为剖宫产术后瘢痕子宫内膜异位症,遂对腹壁肿块进行手术切除,切除时保证有足够的切缘。剖宫产术后瘢痕子宫内膜异位症是腹部肿块的罕见病因;然而,当这种情况急性发作时,可能难以诊断。在本病例中,通过仔细分析患者病史、CT图像和组织病理学结果共同确诊。在全身麻醉下进行手术切除,同时保证有足够的切缘。