Caesarean scar endometriosis presenting as an acute abdomen: a case report and review of literature

K B Gajjar, Ketan Gajjar, Gajjar KB, A A Mahendru, Amita A. Mahendru, Mahendru AA, M A Khaled, Khaled MA
Archives of gynecology and obstetrics · 2007 · vol. 277(2) , pp. 167–169 · doi:10.1007/s00404-007-0431-4 · PMID:17701194 · W2010130279
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-12 ⓘ

This case report and literature review describes a 27-year-old woman with a Caesarean scar endometrioma presenting as an acute abdomen, confirmed by histology after surgical excision.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This paper reports a case of caesarean scar endometriosis presenting as an acute abdomen in a 27-year-old woman with pain and a lump near the left pfannenstiel incision scar, supported by initial investigations and subsequent examination under anesthesia. A tumour-like mass adherent to the skin and surrounding subcutaneous tissue was excised with clear margins, and histology confirmed endometriosis, including a 2 cm fibrotic nodule. The authors also review prior literature and note that, despite increasing caesarean section rates and many proposed preventive practice modifications, there are no published randomized trials. This paper is centrally about endometriosis — specifically caesarean scar endometriosis presenting as an acute abdomen.

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Abstract

ObjectiveTo report a case of Caesarean scar endometriosis presenting as acute abdomen and a review of literature.DesignCase report and literature review.PatientA 27-year-old woman presented in Accident and Emergency Department with pain and lump near left edge of pfannenstiel incision scar.InterventionAfter initial investigations the patient underwent examination under anesthesia.Main outcome measureExcision of a tumour-like mass adherent to the skin and the surrounding subcutaneous tissue. The mass was dissected free from the surrounding fat tissue and excised with clear margins.ResultHistology of the mass confirmed endometriosis in tumour and showed a 2 cm fibrotic nodule within.ConclusionIn light of increasing rate of caesarean section, it is important to emphasize the early diagnosis as well as optimum management of scar endometrioma. Many recommendations have been given to modify practices at caesarean section to prevent transplantation of decidual endometrial tissue in the abdominal scar but without any published randomised trials.
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Abstract

Objective To report a case of Caesarean scar endometriosis presenting as acute abdomen and a review of literature. Design Case report and literature review. Patient A 27-year-old woman presented in Accident and Emergency Department with pain and lump near left edge of pfannenstiel incision scar. Intervention After initial investigations the patient underwent examination under anesthesia. Main outcome measure Excision of a tumour-like mass adherent to the skin and the surrounding subcutaneous tissue. The mass was dissected free from the surrounding fat tissue and excised with clear margins.

Result

Histology of the mass confirmed endometriosis in tumour and showed a 2 cm fibrotic nodule within.

Conclusion

In light of increasing rate of caesarean section, it is important to emphasize the early diagnosis as well as optimum management of scar endometrioma. Many recommendations have been given to modify practices at caesarean section to prevent transplantation of decidual endometrial tissue in the abdominal scar but without any published randomised trials. Access this article We’re sorry, something doesn't seem to be working properly. Please try refreshing the page. If that doesn't work, please contact support so we can address the problem. Similar content being viewed by others

References

Bergqvist A (1993) Different types of extragenital endometriosis: a review. Gynaecol Endocrinol 7:207–221 Wolf GC, Singh KB (1989) caesarean scar endometriosis a review. Obstet Gynaecol Surv 44:89–95 Chatterjee SK (1980) Scar endometriosis: a clinicopathologic study of 17 cases. Obstet Gynaecol 56:81–84 Steck WD, Helwig EB (1965) Cutaneous endometriosis. JAMA 191:101–104 Scholefield HJ, Sajjad Y, Morgan PR (2002) Cutaneous endometriosis and its association with caesarean section and gynaecological procedures. J Obstet Gynaecol 22(5):553–554 Seydel AS, Sickel JZ, Warner ED, Sax HC (1996) Extrapelvic endometriosis: diagnosis and treatment. Am J Surg 171:239 Vorapong P, Surang T (2002) Caesarean section scar endometriosis: a case report and review of the literature. J Med Assoc Thai 85:733–738 Grassi CJ, Alday MR, Costello P (1985) computed tomography appearance of subcutaneous endometrioma. J Comput Tomogr 9:157–159 Bumpers HL, Butler KL, Best IM (2002) Endometrioma of the abdominal wall. Am J Obstet Gynecol 187:1709–1710 Miller DM, Schouls JJ, Ehlen TG (1998) Clear cell carcinoma arising in extragonadal endometriosis in a caesarean section scar during pregnancy. Gynecol Oncol 70:127–130 Philip K, Reid G, Wong F (2002) Caesarean section scar endometriosis: two cases of recurrent disease and a literature review. Aust NZ J Obstet Gynaecol 42(2):218–220 Douglas C, Rotimi O (2004) Extragenital endometriosis–a clinicopathological review of a Glasgow hospital experience with case illustrations. J Obstet Gynaecol 24(7):804–808 Prentice A (2001) Endometriosis. Regular review. BMJ 323:93–95 Khetan N, Torkington J, Watkin A, Jamison MH, Humphreys WV (1999) Endometriosis: presentation to general surgeons. Ann R Coll Surg Engl 81:255–259 Martin RH, Higginbottom J (1973) Hysterectomy and endometriosis. Lancet 7820(July):106 Eogan M, McKenna P (2002) Endometriosis in caesarean section scars. Ir Med J 95(8):247 Tarik Wasfie, Edward Gomez, Silvia Seon, Barina Zado (2002) Abdominal wall endometrioma after Caesarean section: a preventable complication. Int Surg 87:175–177 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Gajjar, K.B., Mahendru, A.A. & Khaled, M.A. Caesarean scar endometriosis presenting as an acute abdomen: a case report and review of literature. Arch Gynecol Obstet 277, 167–169 (2008). https://doi.org/10.1007/s00404-007-0431-4 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-007-0431-4

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Condition tags

endometriosis

MeSH descriptors

Abdomen, Acute Cesarean Section Cicatrix Endometriosis Abdomen, Acute Abdomen, Acute Adult Cicatrix Endometriosis Endometriosis Endometriosis Female Fibrosis Humans

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