Abdominal wall endometriosis in the cesarean section surgical scar: A potential diagnostic pitfall

Abstract

Abdominal wall endometriosis should be considered in the differential diagnosis of masses located at cesarean section incision scars, which should be excised for definitive diagnosis and treatment.

Abdominal Wall Endometrioma: Ultrasonographic Features and Correlation with Clinical Findings

“…In our study, there was only one patient with a history of ovarian endometrioma, which was surgically removed during a previous caesarean section. In general, the characteristic clinical symptom of endometriosis is cyclic pain associated with menstrual periods (8,9). Continuous pain or painless lumps may occur, but has generally been regarded as atypical (11), which may explain why it is clinically often recognised late, as was the case in our patients.…”

“…Approximately 11% of women have undiagnosed endometriosis at the popu- lation level, but it is difficult to accurately determine the prevalence (4-6). Extrapelvic endometriosis affects nearly every organ, except the heart and the spleen, but its most common location is in the abdominal wall (7)(8)(9). When endometriosis develops as a local mass, the lesion is called an endometrioma (10).…”

Case Report of Recurrent Abdominal Wall Endometrioma at the Same Location after Nine Years of Its First Excision

“…Usually a cyclic lower abdominal pain with the menstruation in association or not with changes in the size of the mass is a common complaint among the patients affected by AWE [8]. Furthermore, classical symptoms of endometriosis including dyspareunia and/or dysmenorrhea are related to AWE and increase the clinical suspicion of its diagnosis.…”

“…The latter is present in 81% of the cases [2]. In addition, the incidence of AWE after C-section is estimated between 0,03 and 1,08% [4][5][6][7][8][9].…”

Scar endometriosis: not a rarity now a day

“…1 Endometriosis of the subcutaneous tissue and scar is very rare with an incidence reported to be 0.03 -0.4% of all women undergoing caesarean sections. 2 Although scar endometriosis has been most commonly reported after caesarean sections, other gynecologic surgeries like myomectomy, hysterectomy, hysterotomy, tubal surgeries, appendectomy, amniocentesis, or episiotomy have also been reported to be followed by scar endometriosis. 3 Here author discuss a case of scar endometriosis developing in the scar of previous caesarean section, 5 years after the primary surgery.…”