Scar endometriosis, a tricky diagnosis. A case series report and a short review of the literature

BACKROUND: Abdominal wall endometrioma is a rare condition, which usually develops in surgical scar of a Cesarean section (C-section) or of a hysterectomy. Scar endometriosis is a misdiagnosed condition in general surgery, since it mimics other surgical conditions. Diagnosis is mainly based upon a high index of suspicion. AIM: The purpose of this study is to highlight the characteristics of this rare pathology and assess the diagnostic algorithm and therapeutic options. METHODS: The article is a case series and therefore no specific methods have been applicable. RESULTS: In the current study, we present a case series of seven cases with abdominal pain on the Pfannenstiel incision, treated in our department during a two years period, between 2014 and 2016, followed by a brief review of the literature. CONCLUSION: Scar endometriosis may be difficult to diagnose as it is an unfamiliar entity to general surgeons. This condition can be confused with other surgical conditions. Imaging methods, such as ultrasound or CT-scan should be used for differential diagnosis. The prevention of scar endometriosis may also be important. Surgical excision is the treatment of choice for scar endometriosis.