The challenge in diagnosing abdominal wall endometriosis; a series of three cases

Abdominal wall endometriosis (AWE) is an understudied entity in which many women of childbearing age who have undergone pelvic obstetric surgeries suffer. In this series, we will present three cases of AWE and discuss the diagnostic challenge in this uncommon disease.

These case series describe the different presentations of the entity and the various methods of diagnosing them. Many other reviews have discussed the possible preventative methods to decrease the chances of developing abdominal wall endometrioma.

Women of childbearing age, with a previous C-section or hysterectomy, who present with chronic abdominal pain and bulging related to their wound should raise the suspicion and further go an abdomen pelvic CT scan at the time of menstruation. Diagnosis of abdominal wall endometriomas is usually delayed, as symptoms are non-specific, cyclical, and slowly progressive. After imaging, the patient must undergo surgical excisional biopsy to have a definitive diagnosis.

Abdominal wall endometriomas are only visualized on a CT scan during menstruation, increasing the challenge of diagnosing this entity significantly. To minimize the error in diagnosis, a raised suspicion of this pathology is the key to identifying this issue.