Scar endometriosis: a rare entity

Kanika Dhiman, Sara Guleria, Himang Jharaik
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2022 · vol. 11(9) , pp. 2544 · doi:10.18203/2320-1770.ijrcog20222328 · W4293527388
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-09 ⓘ

Scar endometriosis, a rare condition occurring after surgery involving endometrial manipulation, particularly C-sections, can be diagnosed preoperatively with ultrasound, examination, and history, with surgical excision serving as both diagnostic and therapeutic intervention.

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This paper describes scar endometriosis, a rare form of endometriosis occurring in surgical scars after endometrial manipulation, and notes an incidence of 0.8% that can be hard to diagnose. It highlights that any prior surgery involving endometrial manipulation can lead to scar endometriosis, with cesarean section greatly increasing the risk of abdominal wall endometriosis, and it emphasizes ultrasound along with history and physical examination for preoperative diagnosis. The paper states that surgical excision is the best approach for both diagnosis and treatment, while also recognizing diagnostic difficulty as a key caveat. This paper is centrally about endometriosis — specifically scar (abdominal wall) endometriosis following surgical procedures such as cesarean section.

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Abstract

Endometriosis is described as the presence of functioning endometrial tissue outside the uterine cavity. Scar endometriosis is a rare disease with an incidence of 0.8% and is difficult to diagnose. It can occur after any surgery which involves endometrial manipulation but caesarean section greatly increases the risk of developing abdominal wall endometriosis. Ultrasound is the most accessible imaging modality along with history and physical examination for establishing a preoperative diagnosis. Clinicians should be aware and highly suspicious of endometriosis in women presenting with pain in the abdomen and/or abdominal mass near the scar following both obstetric or gynecologic surgery. Early diagnosis and treatment can prevent emotional as well as physical distress to the patient. Surgical excision is the best for diagnosis as well as treatment.
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Scar endometriosis: a rare entity DOI: https://doi.org/10.18203/2320-1770.ijrcog20222328Keywords: Caesarean section, Scar endometriosis, Surgical excisionAbstract Endometriosis is described as the presence of functioning endometrial tissue outside the uterine cavity. Scar endometriosis is a rare disease with an incidence of 0.8% and is difficult to diagnose. It can occur after any surgery which involves endometrial manipulation but caesarean section greatly increases the risk of developing abdominal wall endometriosis. Ultrasound is the most accessible imaging modality along with history and physical examination for establishing a preoperative diagnosis. Clinicians should be aware and highly suspicious of endometriosis in women presenting with pain in the abdomen and/or abdominal mass near the scar following both obstetric or gynecologic surgery. Early diagnosis and treatment can prevent emotional as well as physical distress to the patient. Surgical excision is the best for diagnosis as well as treatment. Metrics References Jubanyik KJ, Committee F. Extrapelvic endometriosis. Obstetr Gynecol Clin North Am. 1997;24(2):411-40. Nominato NS, Prates LFVS, Lauar I, Morais J, Maia L, Geber S. Caesarean section greatly increases risk of scar endometriosis. Eur J Obstet Gynecol Reprod Biol. 2010;152(1):83-5. Hensen JH, Vriesman AC, Puylaert JB. Abdominal wall endometriosis: clinical presentation and imaging features with emphasis on sonography. Am J Roentgenol. 2006;186(3):616-20. Francica G, Giardiello C, Angelone G, Cristiano S, Finelli R, Tramontano G. Abdominal wall endometriomas near cesarean delivery scars: sonographic and color Doppler findings in a series of 12 patients. J Ultrasound Med. 2003;22(10):1041-7. Kocher M, Hardie A, Schaefer A, McLaren T, Kovacs M. Cesarean-section scar endometrioma: a case report and review of the literature. J Radiol Case Rep. 2017;11(12):16. Cherrabi F, Moukit M, Kouach J, Rahali DM, Dehayni M. Caesarean scar endometriosis: a case report. Int J Reproduct Contracept Obstetr Gynecol. 2018;7(3):1221. Douglas C, Rotimi O. Extragenital endometriosis--a clinicopathological review of a Glasgow hospital experience with case illustrations. J Obstetr Gynaecol. 2004;24(7):804-8.

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