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Case report of caesarean related scar endometriosis and literature review

Introduction: Caesarean related surgical scar endometriosis is a type of extremely rare abdominal wall endometriosis. Slow growing, chronic pain with increasing severity, the women often suffer in silence. Given the latency of symptoms from initial surgery, presentations or referrals are often to...

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Main Authors: A.S., Dayang Nurul Afifah, Abd Malik, Nur Rashidah, M.R., Nurul Nafizah, Ismail, Hamizah, Hamdan, Asmah Hanim
Format: Article
Language:English
Published: Universiti Kebangsaan Malaysia 2023
Subjects:
RB Pathology
RG Gynecology and obstetrics
Online Access:http://irep.iium.edu.my/109558/7/109558_Case%20report%20of%20caesarean%20related%20scar%20endometriosis%20and%20literature%20review.pdf
http://irep.iium.edu.my/109558/
https://www.medicineandhealthukm.com/toc/18/7%20%28suppl%29
https://doi.org/10.17576/MH.2023.s1807
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spelling my.iium.irep.1095582024-01-03T08:51:58Z http://irep.iium.edu.my/109558/ Case report of caesarean related scar endometriosis and literature review A.S., Dayang Nurul Afifah Abd Malik, Nur Rashidah M.R., Nurul Nafizah Ismail, Hamizah Hamdan, Asmah Hanim RB Pathology RG Gynecology and obstetrics Introduction: Caesarean related surgical scar endometriosis is a type of extremely rare abdominal wall endometriosis. Slow growing, chronic pain with increasing severity, the women often suffer in silence. Given the latency of symptoms from initial surgery, presentations or referrals are often to others than obstetricians. We present a case of Caesarean scar endometriosis referred from surgical department. Case Report: A 43 years old, multiparous lady with last child birth via Caesarean section 10 years prior, presented to surgical department with right inguinal mass. She also reported presence on painful lump over the left edge of her Pfannenstiel scar for past 10 years, some months after her Caesarean section. She has been having chronic cyclical pain and palpable lump during her menses which only became increasingly severe more recently. Examination revealed normal skin colour with palpable 2x3 cm hard nodular swelling with irregular border beneath the left edge of Pfannenstiel scar. Ultrasonography revealed subcutaneous nodule measuring 2.5x 2.7 cm with similar echogenicity to the endometrial lining. Surgical excision of the swelling was performed concurrently with surgery for the huge right inguinal mass (lipoma). Histopathologic examination (HPE) findings of the scar mass confirmed the initial diagnosis of scar endometriosis. Discussion: Caesarean section poses highest risk for development of surgical scar endometriosis. Cyclical pain related to menses is highly suggestive of endometriosis. Presence of previous abdominal surgery especially Caesarean section along with pain and subsequent mass should raise the suspicion. Treatment with surgical excision is highly curative with ability to confirm diagnosis through HPE. Nevertheless, prevention is better than cure. Suggested surgical practice is to avoid using the same needle and suture used in uterine closure for rectus and subcutaneous suturing and cleaning of subcutaneous area post rectus closure may reduce the occurrences of scar endometriosis. Universiti Kebangsaan Malaysia 2023-12 Article PeerReviewed application/pdf en http://irep.iium.edu.my/109558/7/109558_Case%20report%20of%20caesarean%20related%20scar%20endometriosis%20and%20literature%20review.pdf A.S., Dayang Nurul Afifah and Abd Malik, Nur Rashidah and M.R., Nurul Nafizah and Ismail, Hamizah and Hamdan, Asmah Hanim (2023) Case report of caesarean related scar endometriosis and literature review. MEDICINE & HEALTH, 18 (7 (Suppl)). p. 101. E-ISSN 2289-5728 https://www.medicineandhealthukm.com/toc/18/7%20%28suppl%29 https://doi.org/10.17576/MH.2023.s1807
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
topic RB Pathology
RG Gynecology and obstetrics
spellingShingle RB Pathology
RG Gynecology and obstetrics
A.S., Dayang Nurul Afifah
Abd Malik, Nur Rashidah
M.R., Nurul Nafizah
Ismail, Hamizah
Hamdan, Asmah Hanim
Case report of caesarean related scar endometriosis and literature review
description Introduction: Caesarean related surgical scar endometriosis is a type of extremely rare abdominal wall endometriosis. Slow growing, chronic pain with increasing severity, the women often suffer in silence. Given the latency of symptoms from initial surgery, presentations or referrals are often to others than obstetricians. We present a case of Caesarean scar endometriosis referred from surgical department. Case Report: A 43 years old, multiparous lady with last child birth via Caesarean section 10 years prior, presented to surgical department with right inguinal mass. She also reported presence on painful lump over the left edge of her Pfannenstiel scar for past 10 years, some months after her Caesarean section. She has been having chronic cyclical pain and palpable lump during her menses which only became increasingly severe more recently. Examination revealed normal skin colour with palpable 2x3 cm hard nodular swelling with irregular border beneath the left edge of Pfannenstiel scar. Ultrasonography revealed subcutaneous nodule measuring 2.5x 2.7 cm with similar echogenicity to the endometrial lining. Surgical excision of the swelling was performed concurrently with surgery for the huge right inguinal mass (lipoma). Histopathologic examination (HPE) findings of the scar mass confirmed the initial diagnosis of scar endometriosis. Discussion: Caesarean section poses highest risk for development of surgical scar endometriosis. Cyclical pain related to menses is highly suggestive of endometriosis. Presence of previous abdominal surgery especially Caesarean section along with pain and subsequent mass should raise the suspicion. Treatment with surgical excision is highly curative with ability to confirm diagnosis through HPE. Nevertheless, prevention is better than cure. Suggested surgical practice is to avoid using the same needle and suture used in uterine closure for rectus and subcutaneous suturing and cleaning of subcutaneous area post rectus closure may reduce the occurrences of scar endometriosis.
format Article
author A.S., Dayang Nurul Afifah
Abd Malik, Nur Rashidah
M.R., Nurul Nafizah
Ismail, Hamizah
Hamdan, Asmah Hanim
author_facet A.S., Dayang Nurul Afifah
Abd Malik, Nur Rashidah
M.R., Nurul Nafizah
Ismail, Hamizah
Hamdan, Asmah Hanim
author_sort A.S., Dayang Nurul Afifah
title Case report of caesarean related scar endometriosis and literature review
title_short Case report of caesarean related scar endometriosis and literature review
title_full Case report of caesarean related scar endometriosis and literature review
title_fullStr Case report of caesarean related scar endometriosis and literature review
title_full_unstemmed Case report of caesarean related scar endometriosis and literature review
title_sort case report of caesarean related scar endometriosis and literature review
publisher Universiti Kebangsaan Malaysia
publishDate 2023
url http://irep.iium.edu.my/109558/7/109558_Case%20report%20of%20caesarean%20related%20scar%20endometriosis%20and%20literature%20review.pdf
http://irep.iium.edu.my/109558/
https://www.medicineandhealthukm.com/toc/18/7%20%28suppl%29
https://doi.org/10.17576/MH.2023.s1807
_version_ 1787131949651853312
score 13.211869

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