Abstract
Introduction Scar endometriosis (SE) is a rare pathology that develops in the scar tissue formed on the anterior abdominal wall usually after a cesarean section. There have been instances of women presenting to emergency or general surgery clinics with abdominal pain due to SE. Materials and Methods This study retrospectively reviews 19 patients who were operated on in our clinic between January 2010 and January 2017 with a prediagnosis of SE and were reported to have SE based on their pathology results. Results The mean age of the patients was 30.8 years (range: 20-49 years). The body mass indexes of 12 (63.2%) patients were ≥ 25. All patients had a history of cesarean section and 9 (47.4%) patients had undergone cesarean section once. With the exception of one patient who had her SE localized in her inguinal region, all patients had a mass localized on their anterior abdominal wall neighboring the incision and complained about cyclic pain starting in their premenstrual periods. The complaints began 2 years after their cesarean section in 10 (52.6%) 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.
Highlights
Scar endometriosis (SE) is a rare pathology that develops in the scar tissue formed on the anterior abdominal wall usually after a cesarean section
This study retrospectively reviewed patients who were monitored and treated for SE diagnosis in our clinic and the results obtained were presented by referring to the literature
With the exception of one patient who had her SE localized in her inguinal region, all patients had a mass localized on their anterior abdominal wall neighboring the incision and they all complained about cyclic pains starting in their premenstrual periods
Summary
Scar endometriosis (SE) is a rare pathology that develops in the scar tissue formed on the anterior abdominal wall usually after a cesarean section. 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. The common symptoms are a mass in the abdominal wall and a cyclic pain associated with menses When palpated, this mass can be confused with lipoma, abscess, hematoma, hernia, granuloma, desmoid tumor, or sarcoma [5, 6]. This mass can be confused with lipoma, abscess, hematoma, hernia, granuloma, desmoid tumor, or sarcoma [5, 6] For this reason, the anamneses of patients should be questioned well, their history of a cesarean section should be revealed, and care should be taken to find out if their pain is of cyclic nature. This study retrospectively reviewed patients who were monitored and treated for SE diagnosis in our clinic and the results obtained were presented by referring to the literature
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