Abdominal wall endometriosis: accuracy of the diagnostic triad

Authors

  • Latha Lakshmi Department of Obstetrics and Gynaecology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  • Vaibhav Londhe Department of Obstetrics and Gynaecology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  • Tejovathy K Department of Obstetrics and Gynaecology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  • Lily Varghese, Department of Obstetrics and Gynaecology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  • Visali J Department of Obstetrics and Gynaecology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  • Aruna Kekre N Department of Obstetrics and Gynaecology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20150722

Abstract

Background: Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity and musculature. The objectives were to study the prevalence, the clinic-pathological presentation and the accuracy of the criteria for diagnosis of abdominal wall endometriosis.

Methods: This is a retrospective observational study done at a tertiary hospital. The study was approved by the ethics committee and the IRB. Data was retrieved from computer generated medical records. Specificity, sensitivity and likelihood ratio along with univariate and multivariable penalized logistic regression analysis of each presenting symptom were done.

Results: Of the 493 cases with genital endometriosis, 45 cases had AWE diagnosed clinically giving a prevalence of 8.3%. Histological diagnosis of AWE was made in 41, while 4 had suture granuloma. Pain, swelling and previous LSCS had sensitivity of 71%, specificity of 100% and the likelihood ratio was 0.29. The presentation was within 6 years after the index surgery of Caesarean section, with the odds ratio of having endometriosis of 19 (95% CI 1.7- 1595) and the P value of 0.016.

Conclusions: The diagnostic triad of previous caesarian section with swelling and pain at the scar site should prompt the possibility of AWE. However, previous LSCS was the only factor that contributed to the presence of abdominal wall endometriosis. 

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Published

2017-02-10

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Original Research Articles