Abdominal Wall Endometriosis Eleven Years After Cesarean Section: Case Report

Ivka Djaković, Vuković A, Ante Vuković, Ivan Bolanča, Bolanča I, Soljačić Vraneš H, Hrvojka Soljačić Vraneš, Krunoslav Kuna, Kuna K
Acta clinica Croatica · 2017 · vol. 56(1) , pp. 162–165 · doi:10.20471/acc.2017.56.01.22 · PMID:29120557 · W2747352794
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This case report describes a 37-year-old woman diagnosed with abdominal wall endometriosis eleven years after a cesarean section, characterized by cyclic abdominal pain and a palpable nodule.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-22 · read from full text ⓘ

This case report describes a 37-year-old woman with abdominal wall endometriosis developing 11 years after a cesarean section, with low abdominal pain that was linked to the menstrual cycle and intensified at the end of bleeding. A painful, palpable nodule was found near the medial portion of a prior Pfannenstiel incision, and an ultrasound-guided biopsy confirmed the diagnosis of endometriosis. The authors note that abdominal wall endometriosis can occur after cesarean or other abdominopelvic surgery and that mimicking conditions contribute to delayed diagnosis, with this patient having symptoms for eight years. This paper is centrally about endometriosis — specifically a case of abdominal wall endometriosis occurring long after cesarean section and managed surgically.

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Abstract

Endometriosis is a common chronic disease characterized by growth of the endometrial gland and stroma outside the uterus. Symptoms affect physical, mental and social well-being. Extrapelvic location of endometriosis is very rare. Abdominal wall endometriosis occurs in 0.03%-2% of women with a previous cesarean section or other abdominopelvic operation. The leading symptoms are abdominal nodular mass, pain and cyclic symptomatology. The number of cesarean sections is increasing and so is the incidence of abdominal wall endometriosis as a potential complication of the procedure. There are cases of malignant transformation of abdominal wall endometriosis. Therefore, it is important to recognize this condition and treat it surgically. We report a case of a 37-year-old woman with abdominal wall endometriosis 11 years after cesarean section. She had low abdominal pain related to menstrual cycle, which intensified at the end of menstrual bleeding. A nodule painful to palpation was found in the medial part of previous Pfannenstiel incision. Ultrasound guided biopsy was performed and the diagnosis of endometriosis confirmed. Surgery is the treatment of choice for abdominal wall endometriosis. Excision with histologically proven free surgical margins of 1 cm is mandatory to prevent recurrence. A wide spectrum of mimicking conditions is the main reason for late diagnosis and treatment of abdominal wall endometriosis. In our case, the symptoms lasted for eight years and had intensified in the last six months prior to surgery.
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Acta clinica Croatica, Vol. 56. No. 1., 2017. Ostalo https://doi.org/10.20471/acc.2017.56.01.22 Abdominal Wall Endometriosis Eleven Years After Cesarean Section: Case Report Ivka Djaković orcid.org/0000-0003-2275-6389 ; Clinical Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia Ante Vuković ; Clinical Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia Ivan Bolanča ; Clinical Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia Hrvojka Soljačić Vraneš ; Clinical Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia Krunoslav Kuna ; Clinical Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia Sažetak Endometriosis is a common chronic disease characterized by growth of the endometrial gland and stroma outside the uterus. Symptoms affect physical, mental and social well-being. Extrapelvic location of endometriosis is very rare. Abdominal wall endometriosis occurs in 0.03%-2% of women with a previous cesarean section or other abdominopelvic operation. Th e leading symptoms are abdominal nodular mass, pain and cyclic symptomatology. Th e number of cesarean sections is increasing and so is the incidence of abdominal wall endometriosis as a potential complication of the procedure. There are cases of malignant transformation of abdominal wall endometriosis. Therefore, it is important to recognize this condition and treat it surgically. We report a case of a 37-year-old woman with abdominal wall endometriosis 11 years after cesarean section. She had low abdominal pain related to menstrual cycle, which intensified at the end of menstrual bleeding. A nodule painful to palpation was found in the medial part of previous Pfannenstiel incision. Ultrasound guided biopsy was performed and the diagnosis of endometriosis confirmed. Surgery is the treatment of choice for abdominal wall endometriosis. Excision with histologically proven free surgical margins of 1 cm is mandatory to prevent recurrence. A wide spectrum of mimicking conditions is the main reason for late diagnosis and treatment of abdominal wall endometriosis. In our case, the symptoms lasted for eight years and had intensified in the last six months prior to surgery. Ključne riječi Endometriosis – pathology; Abdominal wall – pathology; Cesarean section –adverse effects; Cicatrix; Case reports Hrčak ID: 184437 URI Datum izdavanja: 1.3.2017. Posjeta: 9.252 *

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Condition tags

endometriosis

MeSH descriptors

Abdominal Wall Cesarean Section Cicatrix Endometriosis Postoperative Complications Uterine Diseases Abdominal Pain Abdominal Pain Abdominal Wall Abdominal Wall Adult Cicatrix Cicatrix Delayed Diagnosis Endometriosis Endometriosis Endometriosis Endometriosis Female Humans

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