Abdominal wall endometriosis: reports of three cases

Nusrat Mahjabeen, Sara Mahmood
In: BIRDEM Medical Journal · 2025 · vol. 15(2) , pp. 86–89 · doi:10.3329/birdem.v15i2.81832 · W4410939607
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This paper reports three cases of abdominal wall endometriosis following Cesarean sections, where patients experienced painful menstrual scar lumps, with improvements seen after surgery or dienogest treatment.

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This case report describes three patients with abdominal wall endometriosis who presented with cyclic pain and palpable lumps at the sites of previous lower segment Caesarean section scars. Two patients declined surgical intervention and were instead treated with oral Dienogest, while one underwent surgery; all three cases resulted in clinical improvement following these respective management strategies. The authors note that although scar endometriosis is rare, it can be effectively managed through either medical or surgical approaches, with a recommendation for preventive measures during pelvic surgeries to avoid tissue implantation. This paper is centrally about endometriosis — specifically the presentation and management of abdominal wall endometriosis associated with prior Caesarean sections.

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Abstract

Endometriosis is growing of endometrial cells in places other than normal uterine cavity. Endometriosis commonly affects ovaries and fallopian tubes. But it can occur anywhere in the body. Rarely it can develop within the abdominal wall. Abdominal wall endometriosis may happen after Caesarean section or any other pelvic surgery. Patients mainly present with abdominal pain. We are reporting 3 cases of abdominal endometriosis. They had history of lower segment Caesarean sections. They had pain and palpable lumps in the site of previous surgical scars during menstruation. Among the 3 cases, 1 patient underwent surgery and other 2 patients refused to do surgery. Orally Dienogest was administered to those 2 patients. All of them were improved. Scar endometriosis is not very common. There are medical and surgical options of management, among which surgery is more preferred. It can be diagnosed radiologically. Preventive methods should be undertaken to avoid endometrial tissue implantation which leads to scar endometriosis. BIRDEM Med J 2025; 15(2): 86-89
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Abdominal wall endometriosis: reports of three cases DOI: https://doi.org/10.3329/birdem.v15i2.81832Keywords: endometriosis, Caesarean section, abdominal wall, surgical scarAbstract Endometriosis is growing of endometrial cells in places other than normal uterine cavity. Endometriosis commonly affects ovaries and fallopian tubes. But it can occur anywhere in the body. Rarely it can develop within the abdominal wall. Abdominal wall endometriosis may happen after Caesarean section or any other pelvic surgery. Patients mainly present with abdominal pain. We are reporting 3 cases of abdominal endometriosis. They had history of lower segment Caesarean sections. They had pain and palpable lumps in the site of previous surgical scars during menstruation. Among the 3 cases, 1 patient underwent surgery and other 2 patients refused to do surgery. Orally Dienogest was administered to those 2 patients. All of them were improved. Scar endometriosis is not very common. There are medical and surgical options of management, among which surgery is more preferred. It can be diagnosed radiologically. Preventive methods should be undertaken to avoid endometrial tissue implantation which leads to scar endometriosis. BIRDEM Med J 2025; 15(2): 86-89 Downloads 345 366

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endometriosis

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