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Endometriosis in cesarean section surgical scar  [PDF]
Stefanovi? D.,Kerkez M.,?or?evi? Z.,Kne?evi? S.
Acta Chirurgica Iugoslavica , 2007, DOI: 10.2298/aci0702079s
Abstract: Introduction: Endometriosis is the presence of endometrial glands and stroma outside of uterine cavity. It may occur in the abdominal wall scar after the operation in which uterus was opened. In cesarean section scar it occurs in 0.4%. It is in 2/3 patients characterized with triad of: tumor, periodic pain associated with menses and history of cesarean section. The mechanism of endometriosis occurring in the cesarean scar is felt to be secondary to iatrogenic transplantation of endometrium or extrauterine decidual tissue into the incision during the cesarean section. Case outline. Forty years old patient with tumor 4,5x4 cm that appeared in abdominal wall scar one year after second cesarean section, followed by periodic pain and macroscopic changes associated with menses. First diagnosis was granuloma in the surgical scar, but as she had periodic symptoms, diferential diagnosis was endometriosis. Hormonal therapy with contraceptive drugs was ordered. As it was no improvement she was operated. The surgical excision of the tumor including fascia and muscle tissue was done. Sample revealed endometrium after histopathologic examination. Patient was completely recovered and without relapse of symptoms during follow up to date. Conclusion. When there is a tumor in the cesarean section scar or scar after the operation in which uterus or ovarial tube was opened, followed with periodical pain and macroscopic changes associated with menses, endometriosis should be considered. Surgical excision of the tumor is sufficient and patohistological examination confirms diagnosis. .
Cesarean scar endometriosis - Report of two cases  [cached]
Goel P,Sood S,Romilla,Dalal A
Indian Journal of Medical Sciences , 2005,
Abstract: Endometriosis is presence of functioning endometrial tissue outside the uterine cavity. Endometriosis can sometimes occur in a previous surgical scar. Scar endometriosis is rare and difficult to diagnose. It mostly follows obstetrical and gynecological surgeries. This condition is often confused with other surgical conditions. We are reporting two cases of scar endometriosis following cesarean section, which were misdiagnosed as stitch granuloma initially. Medical treatment was not helpful. Both the patients required wide surgical excision of the lesion. The pathogenesis, diagnosis and treatment of this condition are being discussed.
Feasibility of abdominoplasty with Cesarean section
Thabet WN, Hossny AS, Sherif NA
International Journal of Women's Health , 2012, DOI: http://dx.doi.org/10.2147/IJWH.S29362
Abstract: sibility of abdominoplasty with Cesarean section Original Research (2292) Total Article Views Authors: Thabet WN, Hossny AS, Sherif NA Published Date March 2012 Volume 2012:4 Pages 115 - 121 DOI: http://dx.doi.org/10.2147/IJWH.S29362 Received: 21 December 2011 Accepted: 01 February 2012 Published: 16 March 2012 Wael Naeem Thabet1, Ahmad Samir Hossny1, Nadine Alaa Sherif2 1Department of General Surgery, 2Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt Abstract: Abdominoplasty is an esthetic surgical procedure that restores abdominal contouring. Repeated pregnancies combined with advancing maternal age usually lead to lower abdominal skin redundancy and excess fat accumulation. Delivery via Cesarean section adds weakness to the lower abdominal wall muscles and yields a lower transverse Cesarean scar. Some patients request whether abdominoplasty can be performed with Cesarean section in the same setting, to avoid a future surgery. This study was designed to evaluate the outcome of combined abdominoplasty with Cesarean section. The study included 50 pregnant women from September 2009 to June 2010 with an average follow-up period of 9 months. Nine patients (18%) developed wound infection; three of them (6%) developed wound dehiscence. Six patients (12%) developed lower abdominal skin necrosis; three of them (6%) were treated conservatively and healed by secondary intention, while surgical debridement and secondary sutures were needed in the other three patients (6%). Residual abdominal skin redundancy in nine patients (18%), outward bulging of the abdomen and lack of waist definition in 16 patients (32%), and outward bulging of the umbilicus in twelve patients (24%) were the reported unesthetic results. The results were compared with results of 80 abdominoplasties in nonpregnant women.
Feasibility of abdominoplasty with Cesarean section  [cached]
Thabet WN,Hossny AS,Sherif NA
International Journal of Women's Health , 2012,
Abstract: Wael Naeem Thabet1, Ahmad Samir Hossny1, Nadine Alaa Sherif21Department of General Surgery, 2Department of Obstetrics and Gynecology, Cairo University, Cairo, EgyptAbstract: Abdominoplasty is an esthetic surgical procedure that restores abdominal contouring. Repeated pregnancies combined with advancing maternal age usually lead to lower abdominal skin redundancy and excess fat accumulation. Delivery via Cesarean section adds weakness to the lower abdominal wall muscles and yields a lower transverse Cesarean scar. Some patients request whether abdominoplasty can be performed with Cesarean section in the same setting, to avoid a future surgery. This study was designed to evaluate the outcome of combined abdominoplasty with Cesarean section. The study included 50 pregnant women from September 2009 to June 2010 with an average follow-up period of 9 months. Nine patients (18%) developed wound infection; three of them (6%) developed wound dehiscence. Six patients (12%) developed lower abdominal skin necrosis; three of them (6%) were treated conservatively and healed by secondary intention, while surgical debridement and secondary sutures were needed in the other three patients (6%). Residual abdominal skin redundancy in nine patients (18%), outward bulging of the abdomen and lack of waist definition in 16 patients (32%), and outward bulging of the umbilicus in twelve patients (24%) were the reported unesthetic results. The results were compared with results of 80 abdominoplasties in nonpregnant women.Keywords: abdominoplasty, Cesarean section, pregnancy
Scar endometriosis
Pathan Zaheer,Dinesh U,Rao Ravikala
Journal of Cytology , 2010,
Abstract: Endometriosis is the presence of functioning endometrium outside the uterus. Endometriosis rarely occurs in the abdominal wall. Majority of abdominal wall endometriosis occur in or adjacent to surgical scars, following caesarean section or hysterectomy. Laparotomy scar endometriosis following salpingectomy for ectopic pregnancy has rarely been reported. We report a case of scar endometriosis following laparotomy for chronic ectopic, and diagnosed by fine needle aspiration cytology (FNAC). Excision biopsy confirmed the FNAC diagnosis of scar endometriosis.
Reliable clinical and sonographic findings in the diagnosis of abdominal wall endometriosis near cesarean section scar  [cached]
Giampiero Francica
World Journal of Radiology , 2012, DOI: 10.4329/wjr.v4.i4.135
Abstract: AIM: To highlight sonographic and clinical characteristics of scar endometrioma with special emphasis on size-related features. METHODS: Thirty women (mean age 30.6 years, range 20-42 years) with 33 scar endometriomas (mean diameter 27.1 mm, range 7-60 mm) were consecutively studied by Sonography and Color Doppler examination prior to surgery. Pathological examination was available in all cases. RESULTS: The most frequent (24 of 33 nodules, 74%) sonographic B-mode aspect of endometrioma was that of an inhomogenously hypoechoic roundish nodule with fibrotic changes (in the form of hyperechoic spots or strands), a peripheral inflammatory hyperechoic ring, spiculated margins and a single vascular pedicle entering the mass at the periphery. On average, 1.6 cesarean sections were recorded per patient (range 1-3). The median interval between the last cesarean section and admission to hospital was 36 mo (range 12-120 mo) and the median duration of symptoms before admission was 25.7 mo (range 0.5-80 mo). 13 patients had 13 large endometriomas (≥ 30 mm) with a mean lesion diameter of 41.3 ± 9.02 mm (range 30-60 mm). Seventeen women had 20 small endometriomas with a mean lesion size of 18.2 ± 5.17 mm (range 7-26 mm). The mean interval between the last cesarean section and admission to hospital (66.0 mo vs 39.6 mo, P < 0.01) and the mean duration of symptoms before admission (43.0 mo vs 17.4 mo, P < 0.01) were significantly longer in patients with large endometriomas; in addition, a statistically significant higher percentage of patients with large implants had undergone previous inconclusive diagnostic examinations, including either computed tomography/magnetic resonance imaging/fine needle biopsy/laparoscopy (38.4% vs 0%, P < 0.05). On sonography, large endometriomas showed frequent cystic portions and fistulous tracts (P < 0.02), loss of round/oval shape (P < 0.04) along with increased vascularity (P < 0.04). CONCLUSION: Endometrioma near cesarean section scar is an often neglected disease, but knowledge of its clinical and sonographic findings may prevent a delay in diagnosis that typically occurs in patients with larger (≥ 3 cm) endometriomas.
Feasibility of abdominoplasty with Cesarean section [Retraction]  [cached]
Thabet WN,Hossny AS,Sherif NA
International Journal of Women's Health , 2013,
Abstract: The Editor-in-Chief and Publisher of the International Journal of Women’s Health have been alerted by Dr Nadine Sherif, the corresponding author, to unacceptable levels of duplication with a previously published paper: Ali A, Essam A. Abdominoplasty Combined with Cesarean Delivery: Evaluation of the Practice. Aesthetic Plastic Surgery. 2011;35(1):80–86.It is worth noting that this paper was peer-reviewed by two peer-reviewers and the Editor-in-Chief of the International Journal of Women’s Health before publication. The paper concerned is: Thabet WN, Hossny AS, Sherif NA. Feasibility of abdominoplasty with Cesarean section. International Journal of Women’s Health. 2012;4:115–121.
Feasibility of abdominoplasty with Cesarean section [Retraction]
Thabet WN, Hossny AS, Sherif NA
International Journal of Women's Health , 2013, DOI: http://dx.doi.org/10.2147/IJWH.S42793
Abstract: Feasibility of abdominoplasty with Cesarean section [Retraction] Retraction (732) Total Article Views Authors: Thabet WN, Hossny AS, Sherif NA Published Date January 2013 Volume 2013:5 Pages 43 - 44 DOI: http://dx.doi.org/10.2147/IJWH.S42793 Received: 15 January 2013 Accepted: Published: 24 January 2013 The Editor-in-Chief and Publisher of the International Journal of Women’s Health have been alerted by Dr Nadine Sherif, the corresponding author, to unacceptable levels of duplication with a previously published paper: Ali A, Essam A. Abdominoplasty Combined with Cesarean Delivery: Evaluation of the Practice. Aesthetic Plastic Surgery. 2011;35(1):80–86.It is worth noting that this paper was peer-reviewed by two peer-reviewers and the Editor-in-Chief of the International Journal of Women’s Health before publication. The paper concerned is: Thabet WN, Hossny AS, Sherif NA. Feasibility of abdominoplasty with Cesarean section. International Journal of Women’s Health. 2012;4:115–121. Post to: Cannotea Citeulike Del.icio.us Facebook LinkedIn Twitter Readers of this article also read: Feasibility of abdominoplasty with Cesarean section Does social disadvantage affect the validity of self-report for cervical cancer screening? Advantages of nerve-sparing intrastromal total abdominal hysterectomy Letter to editor Dendritic cells fused with different pancreatic carcinoma cells induce different T-cell responses Acceptance of referral for partners by clients testing positive for human immunodeficiency virus Development of a novel niosomal system for oral delivery of Ginkgo biloba extract In vitro evaluation of the effects of graphene platelets on glioblastoma multiforme cells The search for common pathways underlying asthma and COPD Update on first-line treatment of advanced ovarian carcinoma
Abdominal Incisional Endometriosis Following Cesarean Section: Report of 2 Cases
Azam Azargoon,Nahid Azargoon
Journal of Family and Reproductive Health , 2008,
Abstract: "nEndometriosis is described as the presence of functioning endometrial tissue (glands and stroma) outside the uterine cavity. The most common location is within the pelvis. However, extra pelvic endometriosis is a fairly uncommon disorder and difficult to diagnose. It can sometimes occur in a surgical scar. Scar endometriosis is a rare condition and difficult to diagnose. It mostly follows obstetrical and gynecological surgeries. It presents as a painful, slowly growing mass in or near a surgical scar. We report two cases of abdominal wall endometriosis following hysterotomy and cesarean section. Consequently the pathogenesis, diagnosis and treatment are discussed.
Scar Endometriosis: A Case Report of This Uncommon Entity and Review of the Literature  [PDF]
Cihangir Uzun?akmak,Ahmet Gülda?,Hasene ?z?am,Kemal Din?
Case Reports in Obstetrics and Gynecology , 2013, DOI: 10.1155/2013/386783
Abstract: Scar endometriosis is an infrequent type of extrapelvic endometriosis that is rather close together with obstetrical and gynecological surgeries. It is mostly confused with other dermatological or surgical conditions and delays the diagnosis. We report a case of a 50-year-old woman presenting with scar endometriosis 23 years after her last lower segment caesarean section. The epidemiology, diagnosis, pathogenesis, and treatment of the situation are discussed. 1. Introduction Endometriosis is admitted as the presence of endometrial-like stroma and glands outside the uterine endometrial area [1]. It generally occurs in the pelvic sites such as the ovaries, posterior cul-de-sac, uterine ligaments, pelvic peritoneum, bowel, and rectovaginal septum. Extrapelvic endometriosis can be found in unusual places like in the nervous system, thorax, urinary tract, gastrointestinal tract, and in cutaneous tissues unless its most frequent location is the abdominal wall [2]. The main cause of extrapelvic implants is obstetric and gynecological procedures performed during gestation. There are various theories concerning the scar endometriosis. One of them is the direct implantation of the endometrial tissue in scars during the operation [3]. Under proper hormonal stimulus, these cells may proliferate (cellular transport theory) or the neighborhood tissue may undergo metaplasia, which leads to scar endometriosis (coelomic metaplasia theory). By lymphatic or vascular pathways, the endometrial tissue may reach the surgical scar and then generate to scar endometriosis. 2. Case Report A 50-year-old woman presented in February 2011 with the complaint of pain and swelling on the cesarean scar for one year. Additionally she described cyclic bleeding from this mass for 2 months. She previously had three cesarean deliveries, between 1984 and 1988, and one spontaneous vaginal delivery thirty years ago. She described pain above the cesarean scar that increased during the menstruation period and then noticed a swelling above cesarean scar. She declared mild bleeding from this mass that associated with the first days of her menstruation period. Examination revealed an approximately 3?cm wide, tender, strict, and immobile right subcutaneous mass beneath the low segment cesarean scar with a little orifice. Transvaginal and transabdominal ultrasound showed a 4?cm?×?3?cm?×?4?cm, oval-shaped heterogeneous mass within the right rectus abdominus muscle, with no abnormalities of the uterus and ovaries (Figure 1(a)). Figure 1: (a) USG in the transverse plane showing echogenic subcutaneous
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