Cеsarean section scar endometrosis

Goran Malenković, Sanja Tomić, Bratislav Stoiljković
In: Medicinski pregled · 2018 · vol. 71(suppl. 1) , pp. 83–86 · doi:10.2298/mpns18s1083m · W2897189082
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This case report describes a 39-year-old woman diagnosed with endometriosis at her Cesarean section scar after experiencing chronic, cyclical pain at the surgical site.

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This review article defines endometriosis as functional endometrial tissue located outside the uterine cavity, noting that abdominal wall involvement occurs in approximately one percent of women following cesarean delivery. It presents a case study of a thirty-nine-year-old patient who experienced cyclical pain at her surgical scar site and was successfully treated through complete surgical removal of an endometrioma via mini-laparotomy. The authors emphasize that accurate diagnosis relies on identifying endometrial glands, stroma, and hemorrhage, while cautioning that the condition is frequently misdiagnosed as suture granulomas or hernias. This paper is centrally about endometriosis — specifically, it focuses on cesarean section scar endometriosis, also known as abdominal wall endometriosis, highlighting its clinical presentation, diagnostic challenges, and management.

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Abstract

Endometriosis is defined as a functional endometrial tissue outside the uterine cavity. The ectopic endometrial tissue has been identified after gynecologic laparoscopy or laparotomy procedures in the skin, subcutaneous tissues, abdominal and pelvic wall musculature, and it represents amayor cause of acute or chronic recurrent abdominal or pelvic pain resembling the menstrual cycle. The frequency of abdominal wall endometriosis is approximately 1% of all women who had a cesarean delivery. A 39-year-old patient with a history of one prior Cesarean section, presented with continuous cyclical focal pain at the left part of cesarean scar site for the past 16 months, 23 months after Cesarean section. The patient underwent a mini laparotomy, when endometrioma was completely removed surgically. The PH diagnosis of endometriosis was based on the presence of all elements of the endometrial mucosa (glands, stroma and signs of fresh and old hemorrhage) in an inadequate place (anterior abdominal wall). Endometriosis is difficult to diagnose and it is often mistaken for other conditions such as a suture granuloma, incisional hernia, primary or metastatic cancer. Endometriosis can be prevented only with good surgical techniques and clinical practice as well as the proper care during primary surgery.
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Medicinski pregled 2018 Volume 71, Issue suppl. 1, Pages: 83-86 Cеsarean section scar endometrosis Malenković Goran (Faculty of Medicine, Department of Nursing, Novi Sad + Oncology Institute of Vojvodina, Clinic for Operative Oncology, Department of Gynecology, Sremska Kamenica) Endometriosis is defined as a functional endometrial tissue outside the uterine cavity. The ectopic endometrial tissue has been identified after gynecologic laparoscopy or laparotomy procedures in the skin, subcutaneous tissues, abdominal and pelvic wall musculature, and it represents amayor cause of acute or chronic recurrent abdominal or pelvic pain resembling the menstrual cycle. The frequency of abdominal wall endometriosis is approximately 1% of all women who had a cesarean delivery. A 39-year-old patient with a history of one prior Cesarean section, presented with continuous cyclical focal pain at the left part of cesarean scar site for the past 16 months, 23 months after Cesarean section. The patient underwent a mini laparotomy, when endometrioma was completely removed surgically. The PH diagnosis of endometriosis was based on the presence of all elements of the endometrial mucosa (glands, stroma and signs of fresh and old hemorrhage) in an inadequate place (anterior abdominal wall). Endometriosis is difficult to diagnose and it is often mistaken for other conditions such as a suture granuloma, incisional hernia, primary or metastatic cancer. Endometriosis can be prevented only with good surgical techniques and clinical practice as well as the proper care during primary surgery. Keywords: Cesarean Section, Cicatrix, Abdominal Wall, Endometriosis, Postoperative Complications, Laparoscopy, Diagnosis, Differential, Ultrasonography https://doi.org/10.2298/MPNS18S1083M Full text ( 1175 KB) Tomić Sanja (Faculty of Medicine, Department of Nursing, Novi Sad) Stoiljković Bratislav (Oncology Institute of Vojvodina, Clinic for Operative Oncology, Department of Gynecology, Sremska Kamenica)

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endometriosisendometrioma

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