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Abdominal Incision and Injection Sites
Siva P. Raman, MD
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KEY FACTS

  • Imaging

    TERMINOLOGY

    • Definitions

      • Lesions in abdominal wall at either incision or injection sites that may be mistaken for other pathologic conditions

    IMAGING

    • Imaging Recommendations

      • Injection Site Fluid or Gas Collection

        • Injection or Incision Site Hematoma or Seroma

          • Injection or Incision Site Abscess

            • Diabetic Lipodystrophy

              • Keloid (Hypertrophic Scar)

                • Calcified or Ossified Scar

                  • Endometrial Implantation in Abdominal Incision

                    • Tumor Implantation in Incision Sites

                      • Injection Granulomas

                        DIFFERENTIAL DIAGNOSIS

                          DIAGNOSTIC CHECKLIST

                          • Consider

                            Selected References

                            1. Ecker AM et al: Abdominal wall endometriosis: 12 years of experience at a large academic institution. Am J Obstet Gynecol. 211(4):363.e1-5, 2014
                            2. Blanco M et al: Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes. Diabetes Metab. 39(5):445-53, 2013
                            3. Gidwaney R et al: Endometriosis of abdominal and pelvic wall scars: multimodality imaging findings, pathologic correlation, and radiologic mimics. Radiographics. 32(7):2031-43, 2012
                            4. Kluger N et al: Keloid occurring in a tattoo after laser hair removal. Acta Derm Venereol. 89(3):334-5, 2009
                            5. Ogawa R et al: Differential and exclusive diagnosis of diseases that resemble keloids and hypertrophic scars. Ann Plast Surg. 62(6):660-4, 2009
                            6. Sackey AH: Images in clinical medicine. Injection-site lipoatrophy. N Engl J Med. 361(19):e41, 2009
                            7. Kim J et al: Heterotopic ossification developing in surgical incisions of the abdomen: analysis of its incidence and possible factors associated with its development. J Comput Assist Tomogr. 32(6):872-6, 2008
                            8. Radermecker RP et al: Lipodystrophy reactions to insulin: effects of continuous insulin infusion and new insulin analogs. Am J Clin Dermatol. 8(1):21-8, 2007
                            9. Vardar B et al: Incidence of lipohypertrophy in diabetic patients and a study of influencing factors. Diabetes Res Clin Pract. 77(2):231-6, 2007
                            10. Lee SW et al: Abdominal wound tumor recurrence after open and laparoscopic-assisted splenectomy in a murine model. Dis Colon Rectum. 41(7):824-31, 1998
                            11. Reardon MJ et al: Heterotopic calcification in abdominal wounds. Am J Surg. 173(2):145-7, 1997
                            12. Jacobs JE et al: Heterotopic ossification of midline abdominal incisions: CT and MR imaging findings. AJR Am J Roentgenol. 166(3):579-84, 1996
                            13. Valenta LJ et al: Insulin-induced lipodystrophy in diabetic patients resolved by treatment with human insulin. Ann Intern Med. 102(6):790-1, 1985
                            14. Orava S et al: Heterotopic ossification in upper midline abdominal scars. Ann Chir Gynaecol. 69(3):115-8, 1980
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Imaging

                              TERMINOLOGY

                              • Definitions

                                • Lesions in abdominal wall at either incision or injection sites that may be mistaken for other pathologic conditions

                              IMAGING

                              • Imaging Recommendations

                                • Injection Site Fluid or Gas Collection

                                  • Injection or Incision Site Hematoma or Seroma

                                    • Injection or Incision Site Abscess

                                      • Diabetic Lipodystrophy

                                        • Keloid (Hypertrophic Scar)

                                          • Calcified or Ossified Scar

                                            • Endometrial Implantation in Abdominal Incision

                                              • Tumor Implantation in Incision Sites

                                                • Injection Granulomas

                                                  DIFFERENTIAL DIAGNOSIS

                                                    DIAGNOSTIC CHECKLIST

                                                    • Consider

                                                      Selected References

                                                      1. Ecker AM et al: Abdominal wall endometriosis: 12 years of experience at a large academic institution. Am J Obstet Gynecol. 211(4):363.e1-5, 2014
                                                      2. Blanco M et al: Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes. Diabetes Metab. 39(5):445-53, 2013
                                                      3. Gidwaney R et al: Endometriosis of abdominal and pelvic wall scars: multimodality imaging findings, pathologic correlation, and radiologic mimics. Radiographics. 32(7):2031-43, 2012
                                                      4. Kluger N et al: Keloid occurring in a tattoo after laser hair removal. Acta Derm Venereol. 89(3):334-5, 2009
                                                      5. Ogawa R et al: Differential and exclusive diagnosis of diseases that resemble keloids and hypertrophic scars. Ann Plast Surg. 62(6):660-4, 2009
                                                      6. Sackey AH: Images in clinical medicine. Injection-site lipoatrophy. N Engl J Med. 361(19):e41, 2009
                                                      7. Kim J et al: Heterotopic ossification developing in surgical incisions of the abdomen: analysis of its incidence and possible factors associated with its development. J Comput Assist Tomogr. 32(6):872-6, 2008
                                                      8. Radermecker RP et al: Lipodystrophy reactions to insulin: effects of continuous insulin infusion and new insulin analogs. Am J Clin Dermatol. 8(1):21-8, 2007
                                                      9. Vardar B et al: Incidence of lipohypertrophy in diabetic patients and a study of influencing factors. Diabetes Res Clin Pract. 77(2):231-6, 2007
                                                      10. Lee SW et al: Abdominal wound tumor recurrence after open and laparoscopic-assisted splenectomy in a murine model. Dis Colon Rectum. 41(7):824-31, 1998
                                                      11. Reardon MJ et al: Heterotopic calcification in abdominal wounds. Am J Surg. 173(2):145-7, 1997
                                                      12. Jacobs JE et al: Heterotopic ossification of midline abdominal incisions: CT and MR imaging findings. AJR Am J Roentgenol. 166(3):579-84, 1996
                                                      13. Valenta LJ et al: Insulin-induced lipodystrophy in diabetic patients resolved by treatment with human insulin. Ann Intern Med. 102(6):790-1, 1985
                                                      14. Orava S et al: Heterotopic ossification in upper midline abdominal scars. Ann Chir Gynaecol. 69(3):115-8, 1980