[Abdominal wall endometriosis imitating incisional hernia]

Pain and swelling in abdominal wall scars that become more severe on coughing and straining, are typical symptoms of postoperative ventral hernias. Other abdominal wall lesions, such as hematomas, granulomas and neoplasms, can evoke similar symptoms. Usually the diagnosis can be made by physical examination, but occasionally only at operation. Endometriosis in a postoperative scar is rare, and the symptoms are usually associated with the menstrual cycle. We describe a 40-year-old woman who suffered from pain and swelling in a cesarean section scar of 8 years duration. The symptoms worsened on coughing and during exercise. At operation, a 3 x 5 cm nodule was excised from the depths of the scar; endometriosis was found on histopathological examination. Endometriosis should be included in the differential diagnosis of abdominal scar lesions following gynecological operations.