A case series on management of scar endometriosis following C-sections

Tharun Ganapathy Chitrambalam, Sidhu Sekhar, Jeyakumar S., Koshy Mathew Panicker


Endometriosis is presence of functioning endometrial tissue outside the uterine cavity. Endometriosis can sometimes occur in a previous surgical scar. Scar endometriosis is rare and difficult to diagnose. It mostly follows obstetrical and gynecological surgeries. This condition is often confused with other surgical conditions. We are reporting 5 cases of scar endometriosis following cesarean section, some of which were misdiagnosed as stitch granuloma initially. Medical treatment was not helpful. All 5 patients required wide surgical excision of the lesion. The pathogenesis, diagnosis and treatment of this condition are being discussed.


Cesarean section, Hormonal therapy, Scar endometriosis, Wide local excision

Full Text:



Advincula A, Truong M, Lobo RA. Endometriosis: Etiology, Pathology, Diagnosis, Management. 7 ed. Comprehensive Gynaecology. Elsevier; 2019: 423-442.

Allan Z. A case of endometriosis causing acute large bowel obstruction. Int J Surg Case Rep. 2018;42:247-9.

Horton JD, DeZee KJ, Ahnfeldt EP, Wagner M. Abdominal wall endometriosis: a surgeon’s perspective and review of 445 cases. Am J Surg. 2008;196(2):207-12.

Cinardi N, Franco S, Centonze D, Giannone G. Perineal scar endometriosis ten years after Miles ’ procedure for rectal cancer : Case report and review of the literature. Int J Surg Case Rep. 2018;2(6):150-3.

Hogg S. Endometriosis update. Obstet Gynaecol Reprod Med. 2018;28(3):61-9.

Tran-harding K, Nair RT, Dawkins A, Ayoob A, Owen J, Deraney S, et al. Endometriosis revisited : an imaging review of the usual and unusual manifestations with pathological correlation. Clin Imaging. 2018;52(7):163-71.

Marsden NJ. Scar endometriosis : A rare skin lesion presenting to the plastic surgeon. Br J Plast Surg. 2018;66(4):e111-3.

Marques C, Silva TS, Dias MF. Gynecologic Oncology Reports Clear cell carcinoma arising from abdominal wall endometriosis – Brief report and review of the literature. Gynecol Oncol Reports. 2018;20(2017):78-80.

Mubarak SA, Huang K-G, Adlan A-S. Laparoscopic view of abdominal wall endometrioma. Gynecol Minim Invasive Ther. 2016;5:33-5.

Nominato NS, Prates LF, Lauar I, Morais J, Maia L, Geber S. Caesarean section greatly increases risk of scar endometriosis. Eur J Obstet Gynecol. 2018;152(1):83-5.