BATIN DUVARINDA ENDOMETRİOSİS: SEZARYEN SKAR HATTINDAN UZAK ATİPİK LOKASYON

Objective: Abdominal wall endometriosis is seen rarely. Mass lesion, cyclic menstrual pain and previous obstetric or gynecological surgery history facilitates the preoperative diagnosis. Atypical presentation that is distant from the scar line may be encountered in rare cases. We defined secondary infertile patient that was operated in our clinic, having bilateral abdominal wall endometriosis that was located 10 cm far away atypically distant from cesarean scar line. Case presentation: 34 year old, gravida 3, parity 1 ( cesarean section ) patient who had undergone caesarean section 5 years ago admitted to gynecology outpatient clinic with the complaints of secondary infertility and palpable abdominal wall mass. Physical examination revealed pfannensteil incision and bilateral 3 cm painful mass that was located 10 cm distant from the scar line. Ultrasonographic examination revealed oval, 3x4 cm, hyperechogen mass compatible with endometriosis that was located lateral to the rectus muscles bilaterally. Lesions were removed with 1 cm clean margins by incisions to skin and subcutaneous tissue under general anesthesia. Pelvic endometriosis or endometrioma was not detected in the diagnostic laparoscopy. Bilateral methylene blue tubal passage was not monitored in the chromopertubation test. Pathological evoluation resulted as endometriosis. Conclusion:Previous cesarean section in the patient's history was typical. Localization distant from the scar line was atypical. Despite history of secondary infertility for about 2 years and lack of a a significant focus of endometriosis in the abdomen of the patient, atypical localization of endometriosis should be kept in mind