Scar Endometriosis In A Post-Caesarean Scar: A Case Report

Saima Bibi¹, Tallat Farkhanda², Sobia Nawaz³, Amna Iftikhar, Maryam Mushtaq, Iqra Ramzan Associate Professor OBGYN Rawalpindi Medical university, Dean OBGYN Rawalpindi Medical University, Associate Professor Rawalpindi Medical university, Senior Registrar

Rawalpindi medical university, Postgraduate Resident OBGYN Unit-1 Holy Family Hospital Rawalpindi

Introduction

Endometriosis is a chronic, estrogen-dependent inflammatory condition characterised by the presence of endometrial tissue outside the uterine cavity.

Case Report

Scar endometriosis is a rare form, defined as implantation of endometrial tissue at scar site followung OBGYN procedures, presents as a cyclic painful swelling and mimics as hernia or Lipoma at scar site

A 38 years female known case of Epilepsy with a prosthetic valve on anticoagulation therapy and hostory of carsarean delivery 3 years back presented with cyclic swelling at scar site.

Clinical examination revealed approximately 2X3 cm swelling on scar line. USG confirmed the same

Excision of scar site swelling revealed 3X4 cm firm mass (endometriosis) in subcutaneous tissue extending down to the rectus sheath on right angle of scar line. Histopathology of mass confirmed the endometriotic tissue

. Incisional or scar endometriosis has also been described, however with much rarer incidence, estimated to be only 0.03% to 0.15% of all cases of endometriosis. This entity can result in unnecessary procedures, delayed or misdiagnosis and can cause emotional and physical distress to the patient.

Conclusion: Scar endometriosis often mimics with a

variety of clinical conditions, so high degree of suspicion is necessary. Efforts should be aimed at minimizing the transfer of endometrial tissue into the subcutaneous area. Gloves replacement prior to closure can avoid the implantation of endometrial tissue into the scar site.