Cyclical Bleeding from an Abdominal wall Scar: A Clinical Case of Scar Endometriosis

IntroductionScar endometriosis is an uncommon type of extrapelvic endometriosis marked by the presence of functional endometrial tissue within surgical wounds, frequently occurring after obstetric or gynecological surgeries. It usually manifests as a painful lump in the vicinity of a surgical scar, with symptoms that typically intensify during menstruation.CaseWe report the case of a ۲۸-year-old multiparous woman who presented with a ۲-year history of cyclical pain and bleeding from her lower abdominal scar, previously the site of a tubal ligation via mini-laparotomy. Clinical examination revealed a tender, nodular swelling with active bleeding at the scar during menses. Imaging studies revealed a vascular subcutaneous lesion adjacent to the rectus muscle, consistent with scar endometriosis. A wide surgical excision of the nodular scar was carried out. Histopathological analysis confirmed the presence of endometrial glands and stroma within the scar tissue, indicating endometriosis. Postoperative recovery was uneventful, and no recurrence was noted on follow-up. Conclusion This case highlights the importance of recognizing cyclical pain or bleeding at a surgical scar as a crucial sign of scar endometriosis. Prompt diagnosis and conclusive surgical treatment are essential for relieving symptoms and avoiding complications, including recurrence or, in unusual instances, malignant transformation.Keywords: Endometriosis, Cicatrix, Abdominal Wall, Gynecologic Surgical Procedures, Menstruation-Associated Disorders

کلیدواژه ها:

Endometriosis ، Cicatrix ، Abdominal wall ، Gynecologic Surgical Procedures ، Menstruation-Associated Disorders