Parietal endometriosis on cesarean scar: Study of a case

Abstract

Objective: Parietal endometriosis is a rare pathology. It can occur on all scars, most often during surgical procedures with hysterotomy. It affects 0.03 to 0.4% of cesarean scars. Patients and method: we report the case of abdominal wall endometriosis treated in the plastic surgery department of the Ibn Rochd hospital center in Casablanca. Results: The age of our patient is 32 years old. She has two previous cesarean sections with Pfannenstiel type laparotomies. The interval between the intervention and the appearance of symptoms is three years. She presented a clinical picture made up of pain punctuated by the menstrual cycle. The treatment was surgical type of excision. The lesion invades the rectus abdominis muscle. The size of the lesion is 3 cm. There were no complications or recurrence. Discussion and Conclusion: Local endometrial cell transplantation is the most likely pathophysiological mechanism to explain parietal endometriosis. The typical clinical picture combines swelling and pain punctuated by the menstrual cycle, but it is not always complete. Medical imaging makes little contribution. Surgical treatment must be broad enough to avoid any recurrence. No means of prevention has proven its effectiveness.