Scar endometriosis

Case contributed by Ali Mahmoud ali Mohammed

Presentation

Right lower abdominal pain that increases around menstruation. Previous two cesarean sections.

Patient Data

Age: 20 years
Gender: Female

MRI

MRI

An ill-defined heterogeneous soft tissue lesion is seen abutting the right rectus abdominis muscle disrupting the right rectal sheath; it appears iso-intense in T2 and slightly hyperintense in T1 with peripheral hyperintensity and vivid post-contrast enhancement

 

Ultrasound

Ultrasound

Complementary ultrasound showed an irregular hypoechoic lesion related to the right rectus abominis muscle with a peripheral flow signal noted.

Case Discussion

Given the patient's clinical history of abdominal pain near the site of the previous cesarean scar that characteristically increases the day before and the first few days of her menstrual cycle, the radiological picture is consistent with scar endometriosis.  

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