Menstruation from the pfannenstial scar: A case of rare presentation of atypical endometriosis

Ahmad Hanis Omar, Adibah Ibrahim
In: Journal of Case Reports and Images in Obstetrics and Gynecology · 2018 · vol. 4 , pp. 1 · doi:10.5348/100036z08ao2018cr · W2804158342
article OA: diamond CC0 ⤵ 1 in-corpus citation
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This case report describes a 27-year-old woman with cyclical bleeding from her Pfannenstiel scar due to scar endometriosis, which was confirmed histologically after surgical excision.

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Abstract

Introduction: Endometriosis is the presence of functioning endometrium (gland and stroma) in sites other than uterine mucosa, usually in the pelvis, causing dysmenorrhea, dyspareunia, menstrual irregularities, and infertility. Case Report: A 27-year-old, had caesarean section 11 months ago presented to Obstetrics and Gynaecology clinic with cyclical bleeding from her surgical scar from ten months. She noted bleeding from the small nodule over the healed pfannenstial scar on day of her menses. Examination revealed a small reddish nodule 0.5 cmx0.5 cm, non-tender, with two blackish dots on it. Transabdominal ultrasound examination revealed that the nodule confined at the subcutaneous tissue, above the rectus. Diagnosis of scar endometriosis was made. She had wide local excision and recovered well. The histological examination was consistent with scar endometriosis. Conclusion: Scar endometriosis is a very rare condition. Women in the reproductive age with swelling, pain and discharge at the scar following surgery should be suspected for scar endometriosis.

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endometriosisdysmenorrheadyspareuniainfertility

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