1Department of Gynecology and Obstetrics, Clinical Hospital in Tetovo, RN Macedonia.
3Faculty of Medical Sciences, University of Tetovo, RN Macedonia.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2023 Dec 18;44(3):121-126. doi: 10.2478/prilozi-2023-0055. Print 2023 Dec 1.
Abdominal wall endometriosis is atypical localization of the extra-pelvic endometriosis with non-specific symptoms and is difficult for diagnosis. Cesarean scar endometriosis (CSE) is the most common type of abdominal wall endometriosis, which usually develops after obstetric operations. We report a case of a 33-year-old woman who had two previous cesarean sections presented with a mass in the subcutaneous tissue of the abdominal wall, approximately 4 cm superior to the Pfannenstiel incision, 5 years after her second lower segment caesarean section. The classic clinical presentation, imaging findings on ultrasonography and computed tomography are analyzed. Treatment with local surgical excision of the mass is discussed. The diagnosis was confirmed with histopathological analysis of the surgical sample. When it comes to the limited painful lesion in the subcutaneous tissue at the cesarean scar, with a pain intensifying during menstruation, the physician should consider cesarean scar endometriosis in women of reproductive age with a history of cesarean section.
腹壁子宫内膜异位症是盆腔外子宫内膜异位症的非典型定位，具有非特异性症状，难以诊断。剖宫产瘢痕内子宫内膜异位症（CSE）是腹壁子宫内膜异位症最常见的类型，通常发生在产科手术后。我们报告了一例 33 岁女性，她曾有两次剖宫产史，在第二次下段剖宫产术后 5 年，于下腹部横切口上方约 4cm 处的腹壁皮下组织出现一肿块。分析了其典型的临床表现、超声和 CT 影像学检查结果。讨论了局部手术切除肿块的治疗方法。通过对手术样本的组织病理学分析确诊。当涉及到剖宫产瘢痕处皮下组织有限的疼痛性病变，且在月经期间疼痛加剧时，有剖宫产史的育龄妇女应考虑剖宫产瘢痕内子宫内膜异位症。
