Scar endometriosis after a laparotomy for uterine perforation as a complication of dilatation and curettage

BACKGROUND: Ectopic endometriosis is an uncommon disease. Abdominal scar endometriosis is especially rare. CASE: A 38-year-old gravid 1, para 1 woman underwent dilatation and curettage due to an intrauterine infection. During the procedure, uterine perforation occurred and an emergency laparotomy was performed to provide hemostasis and suturing. Three years later, she complained of pain and swelling at the lower end of her abdominal scar during menstruation. A biopsy of the abdominal scar demonstrated endometriosis. The patient elected to receive conservative management rather than a surgical procedure. Therefore, hormonal therapy was initiated. The hormonal therapy provided symptomatic relief and reduced the size of the lesion. CONCLUSION: We reported an extremely rare case of scar endometriosis after a laparotomy for a uterine perforation that occurred as a complication of dilatation and curettage. We suggest that hormonal therapy using gonadotropin-releasing hormone agonist might be an alternative to surgical treatment for ectopic endometriosis.