Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Mar:116:109410.
doi: 10.1016/j.ijscr.2024.109410. Epub 2024 Feb 20.

Parietal endometriosis: An uncommon cause of c-section scar pain - A case report

Hounaida Mahfoud  1 , Samia Tligui  2 , Ibtissam Bensrhir  2 , Najia Zeraidi  2 , Amina Lakhdar  2 , Aziz Baidada  2
Affiliations
Case Reports

Parietal endometriosis: An uncommon cause of c-section scar pain - A case report

Hounaida Mahfoud et al. Int J Surg Case Rep. 2024 Mar.

Abstract

Introduction: Parietal endometriosis is the most common form of extra-pelvic endometriosis. It develops on the surgical scar of c-section or hysterectomy. It is one of the causes of scar pain.

Case presentation: A 26 years old patient presents with recurring pain and swelling of a Pfannenstiel scar 6 years after a caesarean section. Physical examination revealed a firm tender subcutaneous nodule that appeared at MRI as a heterogenous parietal mass infiltrating the rectus abdominis muscles. The patient underwent a wide excision of the nodule.

Discussion: Parietal endometriosis can be the cause of debilitating scar pain even in patients with no history of deep endometriosis. It presents as firm parietal nodule that can become large and infiltrative if left untreated. Diagnosis is purely histological. Surgery remains the treatment of choice and requires a wide excision.

Conclusion: Parietal endometriosis, potentially more common due to rising number of caesarean sections, should be considered with persistent scar pain. Surgery is the preferred treatment, offering a conclusive diagnosis.

Keywords: Caesarean section scar; Catamenial pain; Nodule; Parietal endometriosis; Wide excision.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare that they have no competing interests relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Slight hyperpigmentation of the c-section scar.
Fig. 2
Fig. 2
Ultrasound image of the endometriotic nodule which appears hypoechoic with undistinct borders.
Fig. 3
Fig. 3
Magnetic resonance imaging (MRI) scans. A. Axial view of the nodule embedded in the rectus abdominis muscles. B. Sagittal view of a heterogenous poorly defined parietal mass containing liquid areas.
Fig. 4
Fig. 4
Image of the resected nodule.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Cojocari N., Ciutacu L., Lupescu I., Herlea V., Vasilescu M.E., Sirbu Boeţi M.P. Parietal endometriosis: a challenge for the general surgeon. Chirurgia (Bucur.) 2018;113(5):695. doi: 10.21614/chirurgia.113.5.695. - DOI - PubMed
    1. Marras S., et al. Abdominal wall endometriosis: an 11-year retrospective observational cohort study. Eur. J. Obstet. Gynecol. Reprod. Biol. X. Oct. 2019;4 doi: 10.1016/j.eurox.2019.100096. - DOI - PMC - PubMed
    1. Doroftei B., Armeanu T., Maftei R., Ilie O.-D., Dabuleanu A.-M., Condac C. Abdominal wall endometriosis: two case reports and literature review. Medicina (Mex.) Dec. 2020;56(12):727. doi: 10.3390/medicina56120727. - DOI - PMC - PubMed
    1. Sohrabi C., Mathew G., Maria N., Kerwan A., Franchi T., Agha R.A. The SCARE 2023 guideline: updating consensus surgical CAse REport (SCARE) guidelines. Int J Surg Lond Engl. 2023;109(5):1136. - PMC - PubMed
    1. Horton J.D., Dezee K.J., Ahnfeldt E.P., Wagner M. Abdominal wall endometriosis: a surgeon’s perspective and review of 445 cases. Am. J. Surg. Aug. 2008;196(2):207–212. doi: 10.1016/j.amjsurg.2007.07.035. - DOI - PubMed

Publication types