Caesarean scar endometriosis presenting as an acute abdomen: a case report and review of literature

Abstract

Objective: To report a case of Caesarean scar endometriosis presenting as acute abdomen and a review of literature.

Design: Case report and literature review.

Patient: A 27-year-old woman presented in Accident and Emergency Department with pain and lump near left edge of pfannenstiel incision scar.

Intervention: After initial investigations the patient underwent examination under anesthesia.

Main outcome measure: Excision of a tumour-like mass adherent to the skin and the surrounding subcutaneous tissue. The mass was dissected free from the surrounding fat tissue and excised with clear margins.

Result: Histology of the mass confirmed endometriosis in tumour and showed a 2 cm fibrotic nodule within.

Conclusion: In light of increasing rate of caesarean section, it is important to emphasize the early diagnosis as well as optimum management of scar endometrioma. Many recommendations have been given to modify practices at caesarean section to prevent transplantation of decidual endometrial tissue in the abdominal scar but without any published randomised trials.