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Scar endometriosis

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Previous 2 LSCS Last LSCS - 10 yrs. Lap TL - 5 yrs. C/o Lower Abdominal wall painful swelling in mid line.

Patient Data

Age: 40 years
Gender: Female
ultrasound

In the region of pain indicated by patient ( mid line infraumbilical region - about 2 cm above LSCS scar ), there is an irregular lobulated hypoechoic lesion.

It is predominently on left side. However, smaller extension is noted crossing mid line.

 Left side of the lesion involves full thickness of rectus muscle and extend to subcutanous fat. (37 mm cranio-caudal, 28 mm axial, 20 mm anteroposterior)

Right side of the lesion involves full thickness of rectus muscle without extension into subcutanous fat. (16 mm cranio-caudal, 16 mm axial, 8 mm anteroposterior)

Tiny anechoic areas are noted in lesion. No calcification is noted. Few doppler signals are noted.

No other lesion is noted in vicinity of previous LSCS scar. 

Case Discussion

- In view of clinical background, location of lesion; USG findings favor possibility of

  scar endometriosis.

Surgery - confirmed extent of the lesion.

Histopathology - confirmed endometriosis.

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