Abdominal wall endometriosis: a surgeon's perspective and review of 445 cases

John D. Horton*, Kent J. DeZee, Eric P. Ahnfeldt, Michel Wagner

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

252 Scopus citations


Background: Abdominal wall endometriosis (AWE) is defined as endometrial tissue superficial to the peritoneum. AWE often is misdiagnosed and referred to surgeons for treatment. We performed a systematic review of published cohorts to quantify demographics, symptoms, and outcomes of patients having AWE. Methods: An English language PubMed search from January 1951 to August of 2006 was conducted using several search terms for endometrioma. Conclusions: Twenty-nine articles describing 455 patients were identified and met inclusion criteria. The pooled mean age was 31.4 years. Ninety-six percent presented with a mass, 87% presented with pain, and 57% presented with cyclic symptoms. AWE was associated with a caesarian scar or hysterectomy in 57% and 11% of cases, respectively. The interval from index surgery to presentation was 3.6 years. Recurrence after resection was 4.3%. The most common presentation of AWE is the development of a painful mass after uterine surgery. Surgical treatment appears to result in a cure more than 95% of the time.

Original languageEnglish
Pages (from-to)207-212
Number of pages6
JournalAmerican Journal of Surgery
Issue number2
StatePublished - Aug 2008
Externally publishedYes


  • Abdominal wall endometriosis
  • Cutaneous endometriosis
  • Ectopic endometriosis
  • Extrapelvic endometriosis
  • Incisional endometriosis
  • Scar endometriosis


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