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Endometriosis on laparotomy scar. A three-case report
L Roncoroni1, R Costi, V Violi
1Department of Surgery, Institute of General Surgery and Surgical Therapy, Parma University, School of Medicine, Italy. roncoron@ipruniv.cce.unipr.it
Archives of Gynecology and Obstetrics
|September 20, 2001
Summary
Surgical scar endometriosis is a rare complication after cesarean section. Diagnosis often requires surgical excision, as imaging and cytology are frequently ineffective.
Area of Science:
- Gynecology
- Surgical Pathology
Background:
- Endometriosis of surgical scars, particularly after cesarean section, is an uncommon complication.
- This report details three cases of endometriosis occurring after Pfannenstiel-type laparotomy.
Observation:
- A consistent clinical presentation involved a painful nodule on the laparotomy scar, exacerbated during menstruation.
- Diagnostic imaging (ultrasound) and cytology were found to be unreliable in these cases.
- Histopathological analysis confirmed the presence of endometrial tissue within the scar tissue.
Findings:
- Histopathology revealed well-developed endometrial tissue, including both stromal and glandular components, within a sclerotic stroma.
- The endometrial tissue exhibited cyclical changes consistent with the menstrual cycle.
Implications:
- Accurate clinical history is crucial for suspecting scar endometriosis.
- Surgical excision of the affected scar tissue, including the needle tract if a biopsy was performed, is the recommended diagnostic and therapeutic approach.
- This approach offers definitive diagnosis and treatment for this rare condition.