Vol. 5, Issue 7, Part A (2019)

Background: Implantation of an endometriotic lesion within a pelvic or abdominal wall scar is an uncommon but well-described condition that may be the underlying cause of acute or chronic recurrent abdominal or pelvic pain, especially after cesarean section. Patients with scar endometriosis may be asymptomatic or present with cyclical pain corre¬sponding to the menstrual cycle.

Materials and Methods: A 2 year retrospective study was performed for all cases with a pre-diagnosis of scar endometriosis, and the diagnosis was confirmed on pathological specimen.

Results: The mean age of the patients was 33.5 years (range 25-37 years). All patients had a history of cesarean section. The lesion was present at caesarean section site in all patients. The median interval from symptoms to curative surgical procedure was 13 months (10-28 months). The average size of lesion was 2.6 cm (range 2-4 cm). The complaints began 12 months after their caesarean section in 6 (75%) patients. Mostly abdominal ultrasonography was used for diagnostic purposes. The lesions were totally excised and the SE diagnosis was made through a histopathological examination in all patients. No postoperative complications or recurrences were seen in any of the patients.

Conclusion: Suspicion of SE is essential in women of reproductive age who have a history of cesarean section and complaints of an anterior abdominal wall mass and a pain at the scar site that is associated with their menstrual cycle. An accurate and early diagnosis can be established in such patients through a careful history and a good physical examination and possible morbidities can be prevented with an appropriate surgical intervention.