ABSTRACT
Endometriosis is defined as the presence and growth of endometrial tissue implants, outside the uterine cavity. It is in a episiotomy scar endometriosis that is extremely rare but can lead to significant morbidity in patients due to local infiltration. This condition usually presents with a clinical triad of history of episiotomy, tender nodule at the scar site, and cyclical pain. Here, we report one such rare case of episiotomy scar endometriosis in the perineum of a 30-year-old young female (P1L1) who presented with swelling and pain in the perineal region. The clinical examination and ultrasonography corroborate with the diagnosis of episiotomy scar endometriosis. Excision was done and histopathological examination confirmed the diagnosis. Episiotomy scar endometriosis should always be kept in the differential diagnosis when a lady presents with painful perineal swelling which increases during menstruation. Wide local excision is the treatment of choice and confirmation of the lesion can be done with histopathological examination. If the lesion is not diagnosed within a stipulated period of time, can progress with the involvement of the anal sphincters, and may also turn into a malignant lesion.
ABSTRACT
Perineal endometriosis is a rare entity which can be explained by direct implantation of endometriotic cells over the fresh episiotomy wound and subsequent development of scar endometriosis. Perineal scar endometriosis incidence is reported to be 0.3% to 1%. 28 years old, P1L1, presented with pain and swelling near episiotomy site which is associated with menstruation. Examination during menstruation revealed swelling was tender, erythematous and slightly increased in size. Clinical diagnosis of scar endometriosis was made after clinical examination. Mass excised and sent for histopathological examination. Although diagnosis essentially remains clinical, preoperative evaluation with perineal ultrasound and MRI was performed. Wide local excision remains treatment of choice and follow up for recurrence is recommended. Histopathological examination is obligatory to exclude rare possibility of malignant changes.
ABSTRACT
Background: Endometriosis is defined as the presence and proliferation of the endometrium outside the uterine cavity affecting an estimated 89 million women of reproductive age worldwide. Endometriosis occurs in 5% to 10% of all women, often resulting in debilitating pain and infertility, endometriosis at the scar site known as Scar endometriosis has also been described following obstetrical and gynecological surgery. Scar endometriosis has a much rarer incidence with an illusive presentation and is often misdiagnosed and definitive treatment gets delayed. Objectives of this study was to review the demographic profile, clinical presentation, treatment modalities and outcome in patients with scar endometriosis.Methods: The retrospective study of patients with scar endometriosis managed at DMCH during January 2014 to December 2018 was done.Results: Eight patients of scar endometrosis were diagnosed and operated in our institution over a period of five years. All patients (six with previous caesarean section scar site and two at episiotomy site) presented with tender nodules with pain which got exaggerated during menstruation.Conclusions: A high index of suspicion of scar endometriosis should be kept in patients presented with cyclical pain and tender mass getting exaggerated during menstruation.
ABSTRACT
The presence of functioning endometrium outside the uterine cavity is often encountered in gynaecological practice but an extremely rare entity is its extra pelvic variant is seen sometimes around the umbilicus, anterior rectus sheath vesical region, also rarely seen around the kidney’s nasal mucosa, lungs and the pleura. The incidence of this condition is as low as 0.03% to 0.15%. Endometrioma of the anterior rectus sheath is well documented in literature but because of its rarity may pose a diagnostic dilemma. Reporting herewith a case of anterior rectus sheath endometrioma where medical line of treatment failed and surgical excision was required.
ABSTRACT
Scar endometriosis is a rare entity commonly observed after obstetrical and gynaecological procedures. The diagnosis is often delayed due to the non-specific nature of symptoms. Detailed clinical history of cyclical pain, location in proximity to a surgical scar and a suspicion of this rare entity in women of childbearing age are key to preoperative diagnosis. This is a case of a patient who presented with a troublesome scar after Caesarean section. On Fine needle aspiration cytology (FNAC) a diagnosis of scar endometriosis was provided which was further confirmed on histopathology. Herein we discuss the cytomorphological features of this rare entity and also emphasize the importance of its diagnosis on FNAC which is a rapid and cost-effective method.
ABSTRACT
Endometriosis is defined as the presence of endometrial tissue apart from its usual location. Scar endometriosis is an infrequent type of extra pelvic endometriosis. Viable decidual endometrial cells are likely to be transplanted in the episiotomy wounds during normal delivery and subsequent growth may occur. We present here a case of 22 year old female with perineal endometriosis at the episiotomy site. The clinical, operative and pathological findings are reported.
ABSTRACT
Scar endometriosis is a rare occurrence. Endometriosis is presence of endometrium at ectopic sites, other than the uterine cavity. Though the common sites of endometriosis are pelvic structures, extra pelvic endometriosis is occasionally seen. But presence of endometriosis in previous incision scars is extremely rare. Endometriosis in abdominal incision sites following Cesarean scions, hysterectomy, ovarian endometrioma removal are described. Very few cases of endometriosis at episiotomy site are also described in literature. This case report describes two such cases of scar endometriosis. The first case had scar endometriosis following a laparotomy done for rudimentary horn pregnancy. The second case had endometriosis in the scar of previous laparscopic surgeries, performed for ovarian endometrioma.
ABSTRACT
Endometriosis is presence of functioning endometrial tissue outside the uterine cavity. It can be primary or secondary. It is one of the most frequently misdiagnosed condition. It can pose a diagnostic dilemma and should be included in the differential diagnosis of lumps in abdomen in females. Diagnosis is made by cytological and histological examination. This report evaluates the incidence, path physiology, course, diagnosis, treatment and prevention of this condition. This is a case report of abdominal wall endometriosis following caesarean section.
ABSTRACT
Endometriosis is the presence of functioning endometrium outside the uterus. Endometriosis rarely occurs in the surgical scar of abdominal wall and is difficult to diagnose without pathological assessment. The symptoms are non-specific, typically involving cyclic abdominal wall pain around the incision site at the time for menstruation. It commonly occurs following obstetrical or gynaecological surgical procedures. We report a case of scar endometriosis following caesarean section.
ABSTRACT
Endometriosis is defined as condition, which is ectopic location of endometrial tissue other than uterus and cause many clinical symptoms. Among extrapelvic endometriosis, scar endometriosis secondary to surgery or procedure is very rare condition. We have experienced one interesting case of endometrioma in uterine wall cesarean section scar. The diagnosis was confirmed by histopathologic examination of the scar tissue taken after total abdominal hysterectomy.
Subject(s)
Female , Pregnancy , Cesarean Section , Cicatrix , Endometriosis , UterusABSTRACT
The most frequent ectopic locations of endometriosis include, in descending order of frequency, the ovaries, uterine ligaments, the rectovaginal septum, and peritoneum covering the pelvic organs, that is, uterus, fallopian tubes, rectum, sigmoid colon, and bladder. Endometriosis at the site of episiotomy scar and abdominal scar following cesarean section are very rare conditions among the extrapelvic endometriosis. We have experienced two cases of endometriosis. One occurred from episiotomy scar and the other occurred from abdominal scar following cesarean section. The diagnosis of scar endometriosis is suggested if the symptoms are cyclic or in association with the patient's menstrual cycle. We can use ultrasonography, computerized tomography, magnetic resonance imaging to differentiate from other tumors. Surgical excision is the method of choice for diagnosis and treatment. We report the two cases with review of rare extrapelvic endometriosis.