Fluid-filled cesarean scar niche

Case contributed by Dr Servet Kahveci

Presentation

Pelvic pain in a patient with history of two cesarean deliveries

Patient Data

Age: 40 years
Gender: Female

Transvaginal

ultrasound

A  triangular fluid collection, in keeping with fluid-filled cesarean scar niche is demonstrated.

Case Discussion

Cesarean scar niche refers to myometrial defect and tethering of the endometrium in the region of the old cesarean scar. It can have different shapes but are most commonly semicircular or triangular. Blood may persist in the niche after menstruation and may serve as a source of dysfunctional uterine bleeding.

The differential diagnosis for fluid-filled cesarean niche includes nabothian cysts, prominent vessels and small fibroids.

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