Scar endometriosis can be located in the skin, subcutaneous tissue, rectus muscle/sheath, intraperitoneally, or in the uterine myometrium (within uterine scar). This case is an example of the intraperitoneal location.

In this case, the patient presented with a clinical history of cyclical lower abdominal pain with tenderness on palpation associated with the menstrual cycle that is almost typical clinical history for the endometriosis

Radiologically, the lesion is located along the surgical line of the cesarian section scar and is closely related to the uterine scar. It elicits a hemorrhagic signal that is one of the most common radiological presentations of endometriosis and is associated with uterine adenomyosis. All these features are highly suggestive of scar endometriosis

Ultrasound contribution by Dr/Samar El Sawy