Rectus Abdominis Muscle Endometriosis Developing in A Post-Cesarean Scar: an Uncommon Presentation
Somri Bilel*, Hannachi Mohamed Amine, Samaali Khaoula, Zangar Salim, Jelloul Rayhane, Mizouni Rihab, Bamri Mohamed Aziz, Malek Monia and Neji Khaled
ABSTRACT
Introduction: Abdominal wall endometriosis (AWE) is a rare form of extrapelvic endometriosis, often secondary to obstetric or gynecologic surgery, particularly cesarean section. It presents with cyclical pain and may mimic other abdominal wall pathologies.
Case Presentation: We report the case of a 39-year-old woman with a history of three cesarean deliveries and cholecystectomy, who presented with cyclic periumbilical pain near her cesarean section scar. Ultrasound revealed two heterogeneous hyperechoic masses adjacent to the scar. MRI demonstrated a 72 × 40 × 16 mm endometriotic lesion within the left rectus abdominis muscle invading the superficial aponeurosis and subcutaneous tissue, while sparing the deep aponeurosis and intra-abdominal organs.
Intervention and Outcome: The diagnosis of scar endometriosis was made. Surgical excision was planned for definitive treatment.
Conclusion: Abdominal wall endometriosis should be suspected in women with cyclical pain at or near a cesarean section scar. MRI plays a crucial role in diagnosis and preoperative planning.
