Published: 2021-04-23

Scar endometriosis-rare and painful entity: a case report

Anita Yadav, Jyoti Baghel, Rajneesh Rawat, Avinash Prakash


Scar endometriosis is a rare type of extra-pelvic endometriosis that develops following obstetrical and gynecological surgeries. It is a rare entity, though probably on the rise, due to the increase in caesarean sections performed worldwide. This manuscript reports a rare case of scar endometriosis involving rectus sheath following repeat caesarean section and was managed at a tertiary level centre. The patient required surgical excision of the lesion and was kept on regular follow-up following surgery. The physiopathology of scar endometriosis is complex; its symptomatology is rich and diverse but detailed history, thorough clinical examination along with imaging and histopathological evaluation is usually efficient in diagnosing the condition.


Endometriosis, Caesarean section, Scar endometriosis

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Acién P, Velasco I. Endometriosis: a disease that remains enigmatic. ISRN Obstet Gynecol. 2013 Jul 17;2013:242149.

Machairiotis N, Stylianaki A, Dryllis G, Zarogoulidis P, Kouroutou P, Tsiamis N, et al. Extrapelvic endometriosis: a rare entity or an under diagnosed condition? Diagn Pathol. 2013;8:194.

Sharma M, Nautiyal R, Chaturvedi J, Bhargava S. Scar endometriosis following caesarean section: a rare case report. Int J Reprod Contracept Obstet Gynecol 2015;4:884-6.

Chatterjee SK. Scar endometriosis: a clinicopathologic study of 17 cases. Obstet Gynecol. 1980;56(1):81-4.

Wolf Y, Haddad R, Werbin N, Skornick Y, Kaplan O. Endometriosis in abdominal scars: a diagnostic pitfall. Am Surg. 1996;62(12):1042-4.

Blanco RG, Parithivel VS, Shah AK, Gumbs MA, Schein M, Gerst PH. Abdominal wall endometriomas. Am J Surg. 2003;185(6):596-8.

Scott RB, Linde RW. Clinical external endometriosis; probable viability of menstrually shed fragments of endometrium. Obstet Gynecol. 1954;4(5):502-10.

Ding DC, Hsu S. Scar endometriosis at the site of cesarean section. Taiwan J Obstet Gynecol. 2006;45(3):247-9.

Biswas BK, Gupta N, Magon N. Incisional endometriosis: A rare cause for a painful scar - A report and commentary. Niger Med J. 2012;53(4):257-9.

Celik M, Bülbüloglu E, Büyükbese MA, Cetinkaya A. Abdominal wall endometrioma: Localizing in rectus abdominus sheath. Turk J Med Sci. 2004;34:341-3.

Pathan SK, Kapila K, Haji BE, Mallik MK, Al-Ansary TA, et al. Cytomorphological spectrum in scar endometriosis: a study of eight cases. Cytopathology. 2005;16(2):94-9.

Al-Jabri K. Endometriosis at caesarian section scar. Oman Med J. 2009;24(4):294-5.

Uçar MG, Şanlıkan F, Göçmen A. Surgical Treatment of Scar Endometriosis Following Cesarean Section, a Series of 12 Cases. Indian J Surg. 2015;77(S2):682-6.

Horton JD, Dezee KJ, Ahnfeldt EP, Wagner M. Abdominal wall endometriosis: a surgeon's perspective and review of 445 cases. Am J Surg. 2008;196(2):207-12.

Zhang J, Liu X. Clinicopathological features of endometriosis in abdominal wall--clinical analysis of 151 cases. Clin Exp Obstet Gynecol. 2016;43(3):379-83.