Abdominal wall endometriosis

Abstract

A 41-year-old female with a history of pelvic endometriosis and left ovarian cystectomy presented with wound discharge two weeks post-surgery; biopsy confirmed subcutaneous endometriosis. Seven months later, she was readmitted with severe abdominal pain (8/10) and edema in the right iliac fossa. CT and ultrasound revealed
a 179 cc multiloculated collection in the abdominal wall with muscular extension. Immediate surgery was dismissed due to the risk of lesion expansion. Management was initiated with Pregabalin 75 mg orally every 12 hours, initially for one week, achieving pain control. Subsequently, image-guided percutaneous drainage was performed, extracting 75 cc of chocolate-colored fluid with histological confirmation of endometrial tissue. The patient showed significant clinical improvement, continued neuromodulatory therapy with Pregabalin 75 mg orally every 12 hours for 3 months, and was finally assessed and managed by the minimally invasive gynecologic surgery and abdominal wall unit, undergoing successful surgical treatment.