Intramuscular Abdominal Wall Endometriosis Treated By Ultrasound-Guided Ethanol Injection

Abstract

Abdominal wall endometriosis (AWE) is a rare condition, which usually develops in a surgical scar resulting from a Caesarean section. While commonly seen in the cutaneous and subcutaneous fat tissue at the Caesarean scar level, its intramuscular localisation is quite rare. Its treatment options consist of the excision of the lesion and/or hormonal therapies, although wide surgical excision is the treatment of choice in the literature. Wide surgical excision may create a defect in the abdominal wall and the risk of hernia formation and mesh complications also increases. This case report describes the clinical and radiological findings and treatment modalities of endometriosis that has appeared in the rectus abdominis muscle of a 25-year old patient at the Caesarean scar level. Sclerotherapy may used for endometrioma. We present a new and alternative treatment method using ultrasound guided intralesional ethanol injection for AWE. Compared with the complications of surgical excision, the complications of sclerotherapy by ethanol are at a more acceptable level. So, sclerotherapy by ethanol injection may be an alternative treatment to surgery.