Open AccessAbdominal wall endometriosis in a region distant to the caesarean section scar
Author(s) -
Nicolas Galazis,
C. Kyriacou,
Carina Johnstone-Ayliffe,
Magdy Nawar
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-229889
Subject(s) - medicine , endometriosis , nodule (geology) , caesarean section , abdominal wall , surgery , abdominal pain , medical history , general surgery , pelvic pain , rare disease , radiology , pregnancy , gynecology , pathology , disease , paleontology , genetics , biology
Abdominal wall endometriosis (AWE) is a rare entity presenting as a painful lump with a cyclical pattern, associated with previous caesarean section (CS). AWE is typically located at the site of the CS scar. The diagnosis is challenging in the rare instance when AWE presents at a location distant to the CS scar. A 37-year-old patient presented to a general surgeon with a 2-year history of left-sided, periumbilical pain exacerbated during her menstrual periods. A 3 cm firm and tender nodule was noted clinically. Intraoperatively, the nodule involved the rectus muscle and infiltrated the peritoneum. Histology confirmed endometriosis, and the patient recovered uneventfully. The rarity of this clinical entity and the fact that AWE mostly presents to non-gynaecologists make the diagnosis challenging prolonging its physical and psychological morbidity. Thorough history-taking with emphasis on the pattern of pain and a previous history of CS should raise suspicion of AWE.