Korean J Obstet Gynecol.  2012 Jul;55(7):517-521. 10.5468/KJOG.2012.55.7.517.

A Case of Reconstruction of Abdominal Fascia Using Polypropylene Mesh for Patient of Abdominal Wall Endometriosis After Cesarean Section

• Kim SM
• Kim HK
• Namkung J
• Song JY
• Jung IC
• Cho HH
• Kwon DJ
• Lew YO
• Kim EJ
• Kim JH
• Kim MR

• KMID: 1992563
• DOI: http://doi.org/10.5468/KJOG.2012.55.7.517

Abstract

Endometriosis is defined by the presence of endometrial glands and stroma outside uterine cavity showing variable clinical symptoms under effect of estrogen. The occurrence rate of abdominal wall endometriosis after cesarean section is rare making diagnosis difficult. The case of a 36-year-old female presenting with the very painful mass and pain arising in the caesarean section scar is reported. The curable treatment of abdominal wall endometriosis is the surgical removal of all the pathological tissue, through a large excision. The involved fascia was widely excised and the abdominal wall was reconstructed using polypropylene mesh.

Keyword

Abdominal wall endometriosis; Polyproplylene mesh

MeSH Terms

Abdominal Wall
Adult
Cesarean Section
Cicatrix
Endometriosis
Estrogens
Fascia
Female
Humans
Polypropylenes
Pregnancy
Estrogens
Polypropylenes

Figure

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  Fig. 1 Magnetic resonance imaging finding shows low signal mass in anterior rectus abdominis muscle under previous Cesarean section scar.

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  Fig. 2 (A) Bladder (arrow) is adhered to anterior abdominal peritoneal wall. (B) Fascia is invaded by endometrial tissue (arrows) and thickened about 4 cm depth.

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  Fig. 3 Polypropylene mesh is applied for replacement of fascia defect after removal of endometrial tissue.

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  Fig. 4 (A) Gross view of resected endometrial mass from the fascia of abdominal wall. The margin of mass is irregular, tinged with dark brown colored spotts. (B) No abnormal finding in uterus.

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  Fig. 5 Microscopic finding of abdominal wall mass: development of secretory endometrial glands surrounded by stroma (H&E, ×100).

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