Bleeding abdominal scar endometriosis-a case report

Badal Das, Malay Sarkar, Debobroto Roy, Krishna Pada Das, Nazmin Khatun, Aritrick Moulick
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2021 · vol. 10(8) , pp. 3239 · doi:10.18203/2320-1770.ijrcog20212990 · W3184736990
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⚙ AI-generated summary by claude@2026-06, 2026-06-11 ⓘ

This case report describes a rare presentation of abdominal scar endometriosis in a 28-year-old woman, manifesting as active bleeding from her LSCS scar during menstruation, confirmed by wide excision and histopathology.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text ⓘ

This paper reports a rare case of abdominal scar endometriosis in a 28-year-old woman with a prior low segment caesarean section, presenting with recurrent swelling and active bleeding from the LSCS scar specifically during menstruation. Routine investigations and coagulation were normal, and ultrasonography showed a firm mass; wide excision followed by histopathological examination confirmed the diagnosis. The authors highlight the major limitation that the evidence is limited to a single case report without broader generalizability. This paper is centrally about endometriosis — it describes bleeding abdominal scar endometriosis arising in a prior cesarean section scar.

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Abstract

Presence of functional endometrial tissue anywhere outside the uterine mucosa is called endometriosis. It is hormone dependent and almost exclusively it affects the women of reproductive age. Abdominal scar endometriosis is a rare condition and it is due to deposition of endometriotic tissue in the wound site during various obstetric or gynecological operative procedures. Scar endometriosis followed by lower segment caesarean section (LSCS) is very rare and presents with co-menstrual pain and bleeding. Our case presented with active bleeding from abdominal LSCS scar during menstruation which is extremely a rare presentation. Wide excision and histo-pathological examination confirm the diagnosis. A 28-year-old lady with previous history of LSCS 2 years back presented with complaining of swelling and bleeding from the previous LSCS scar during menstruation, persisting for 4-5 days, repeatedly in every menstrual cycle for last 6 months. On examination a swelling with active bleeding from it was noted over the previous LSCS scar. Routine investigation and coagulation profile was with in normal limit and on ultrasonography a firm mass was noted. After wide excision and histo-pathological Examination, the diagnosis was confirmed. Co-menstrual swelling, pain and bleeding from the previous LSCS scar should not be neglected and may be due to scar endometriosis.
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Bleeding abdominal scar endometriosis-a case report DOI: https://doi.org/10.18203/2320-1770.ijrcog20212990Keywords: Scar Endometriosis, LSCS, Endometriotic tissue, Histo-pathological, Rectus abdominis, HysterotomyAbstract Presence of functional endometrial tissue anywhere outside the uterine mucosa is called endometriosis. It is hormone dependent and almost exclusively it affects the women of reproductive age. Abdominal scar endometriosis is a rare condition and it is due to deposition of endometriotic tissue in the wound site during various obstetric or gynecological operative procedures. Scar endometriosis followed by lower segment caesarean section (LSCS) is very rare and presents with co-menstrual pain and bleeding. Our case presented with active bleeding from abdominal LSCS scar during menstruation which is extremely a rare presentation. Wide excision and histo-pathological examination confirm the diagnosis. A 28-year-old lady with previous history of LSCS 2 years back presented with complaining of swelling and bleeding from the previous LSCS scar during menstruation, persisting for 4-5 days, repeatedly in every menstrual cycle for last 6 months. On examination a swelling with active bleeding from it was noted over the previous LSCS scar. Routine investigation and coagulation profile was with in normal limit and on ultrasonography a firm mass was noted. After wide excision and histo-pathological Examination, the diagnosis was confirmed. Co-menstrual swelling, pain and bleeding from the previous LSCS scar should not be neglected and may be due to scar endometriosis. Metrics References Bazot M, Darai E, Hourani R, Thomassin I, Cortez A, Uzan S et al. Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology. 2004;232:379-89. Kafkasli A, Franklin RR, Sauls D. Endometriosis in the uterine wall cesarean section scar. Gynecol Obstet Invest. 1996;42:211-3. Taff L, Jones S. Cesarean scar endometriosis: A report of two cases. J Reprod Med. 2002;47:50-2. Goel P, Sood SS, Dalal A, Romilla Cesarean scar endometriosis: Report of two cases. Indian J Med Sci. 2005;59:495-8. Kataoka ML, Togashi K, Yamaoka T, Koyama T, Ueda H, Kobayashi H et al. Posterior cul-de-sac obliteration associated with endometriosis: MR imaging evaluation. Radiology. 2005;234:815-23. Kinkel K, Frei KA, Balleyguier C, Chapron C. Diagnosis of endometriosis with imaging: A review. Eur Radiol. 2006;16:285-98. Balleyguier C, Chapron C, Chopin N, Helenon O, Menu Y. Abdominal wall and surgical scar endometriosis: Result of magnetic resonance imaging. Gynecol Obstet Invest. 2003;55:220-4. Tafazoli F, Reinhold C. Uterine adenomyosis: Current concepts in imaging. Semin Ultrasound CT MR. 1999;20:267-77. Lahiri AK, Sharma K, Ashim K, Busiri N. Endometriosis of the uterine cesarean section scar-A case report. Indian J Radiol Imaging. 2008;18(1):66-8.

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