Incisional endometriosis: an underappreciated diagnosis in general surgery
1Department of Surgery, Santa Barbara Cottage Hospital, CA 93105, USA.
Journal of the American College of Surgeons
|April 11, 2000
Summary
Incisional endometriosis, often mistaken for other conditions, typically presents as a painful lump in women with a history of cesarean section. Increased surgeon awareness can improve preoperative diagnosis and management.
Area of Science:
- General Surgery
- Gynecologic Surgery
- Pathology
Background:
- Incisional endometriosis is an underrecognized clinical entity among general surgeons, frequently misdiagnosed preoperatively.
- Only 32 cases have been reported in general surgery literature, highlighting a diagnostic gap.
Purpose of the Study:
- To retrospectively review cases of incisional endometriosis.
- To identify clinical factors aiding in preoperative diagnosis.
Main Methods:
- Retrospective review of 10 incisional endometriosis cases.
- Analysis of pathology specimens from January 1990 to December 1998.
Main Results:
- All 10 patients had prior cesarean sections (Pfannenstiel or lower midline incision).
- The most common symptom was a slow-growing, painful lump at the incision site.
- Mean age was 33.4 years, with symptom duration ranging from 2 months to 3 years.
Conclusions:
- Incisional endometriosis may be more prevalent than previously thought, particularly in women with cesarean section history.
- A painful, slow-growing lump at the incision warrants consideration for incisional endometriosis.
- Enhanced surgeon awareness is crucial for accurate preoperative evaluation and appropriate therapy, potentially avoiding further diagnostic studies.
