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Archive for October 3, 2017

Academic OB/GYN Cases – Large Abdominal Wall Endometrioma with Mesh Reconstruction

Case:

 

41 year old woman with a history of an abdominal myomectomy followed by a pregnancy, ending in cesarean delivery.  Over time a firm mass could be felt in the abdominal wall which was swollen with her menses.  She had been seen by several physicians who were unable to clearly diagnose the mass.  She eventually was diagnosed by a new PCP, and was referred to our office for treatment.

On being seen in our office, we ordered and reviewed MRI images, which demonstrated abdominal wall endometriosis replacing a large segment of the left rectus abdominus muscle and overlying fascia.

 

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These images demonstrated the mass to be approximately 4 x 3 cm in size, with marked gadolinium enhancement in several areas.

A plan was made to do a laparotomy, with expectation that after removal there would be a significant defect in the fascia, likely requiring mesh repair.

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