[Abdominal wall endometriosis imitating incisional hernia]

Area of Science:

• Gynecologic Surgery
• Surgical Pathology
• Abdominal Wall Surgery

Background:

• Postoperative ventral hernias present with abdominal scar pain and swelling, often exacerbated by exertion.
• Differential diagnosis for abdominal wall lesions includes hematomas, granulomas, neoplasms, and less commonly, endometriosis.
• Endometriosis in surgical scars is rare and typically presents with cyclical symptoms related to menstruation.

Observation:

• A 40-year-old woman presented with an 8-year history of pain and swelling in a cesarean section scar.
• Symptoms worsened with coughing and exercise, mimicking a hernia.
• A 3 x 5 cm nodule was excised from the scar tissue.

Findings:

• Histopathological examination confirmed endometriosis within the excised scar nodule.
• The patient's symptoms were persistent and not clearly linked to her menstrual cycle.
• This case demonstrates a non-cyclical presentation of scar endometriosis.

Implications:

• Endometriosis should be considered in the differential diagnosis of abdominal scar lesions, particularly after gynecological surgery.
• Diagnostic challenges exist when scar endometriosis lacks typical cyclical symptoms.
• Accurate histopathological examination is crucial for diagnosing rare scar pathologies.