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Caesarean scar endometriosis: how to make an accurate diagnosis
  1. Senapathige Nilan Kalidasa Rodrigo1,2,
  2. Iranthi Kumarasinghe1 and
  3. Eranda Diyagama Gunasekera1
  1. 1Clinical Sciences, General Sir John Kotelawala Defence University Faculty of Medicine, Ratmalana, Sri Lanka
  2. 2Obstetrics and Gynaecology, Navy General Hospital Colombo, Puttalam, Sri Lanka
  1. Correspondence to Dr Senapathige Nilan Kalidasa Rodrigo; nilan.rodrigo{at}kdu.ac.lk

Abstract

Caesarean scar endometriosis is a rare condition characterised by the presence of endometrial tissue within a surgical scar following a caesarean section. A woman in her late 30s presented with a painful lump beneath her caesarean section skin scar, worsening during menstruation. Despite a previous incision and drainage procedure for a ‘scar abscess’, the symptoms persisted. Ultrasound imaging revealed a cystic lesion beneath the scar. A diagnosis of scar endometriosis was made, and surgical excision was performed. The patient remained symptom-free at 2-year follow-up postsurgery. Histopathology confirmed the presence of endometrial glands and stroma within the scar tissue. This case demonstrates that a reliable diagnosis of caesarean section endometriosis could be made with a triad of symptoms of a cyclic painful mass at the site of a caesarean section scar. Imaging is helpful in excluding other differential diagnoses. Diagnosis can be confirmed with histopathology and treated with complete surgical excision.

  • Pain
  • Cesarean Section
  • Reproductive medicine
  • Pregnancy

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: SNKR, EDG, IK. The following authors gave final approval of the manuscript: SNKR, EDG, IK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.