Abdominal Wall Endometriosis Presenting as a Bloody Mass in a Patient with a History of Four Cesarean Sections.
Jawad, H. (2025). Abdominal Wall Endometriosis Presenting as a Bloody Mass in a Patient with a History of Four Cesarean Sections.. EKB Journal Management System, 1(2), 39-45. doi: 10.21608/aaogj.2025.391113.1016
Hanan Jawad. "Abdominal Wall Endometriosis Presenting as a Bloody Mass in a Patient with a History of Four Cesarean Sections.". EKB Journal Management System, 1, 2, 2025, 39-45. doi: 10.21608/aaogj.2025.391113.1016
Jawad, H. (2025). 'Abdominal Wall Endometriosis Presenting as a Bloody Mass in a Patient with a History of Four Cesarean Sections.', EKB Journal Management System, 1(2), pp. 39-45. doi: 10.21608/aaogj.2025.391113.1016
Jawad, H. Abdominal Wall Endometriosis Presenting as a Bloody Mass in a Patient with a History of Four Cesarean Sections.. EKB Journal Management System, 2025; 1(2): 39-45. doi: 10.21608/aaogj.2025.391113.1016

Abdominal Wall Endometriosis Presenting as a Bloody Mass in a Patient with a History of Four Cesarean Sections.

Aswan Africa Obstetrics and Gynecology Journal
Volume 1, Issue 2 - Serial Number 1, June 2025, Page 39-45  XML PDF (417.2 K)
Document Type: Case Reports
DOI: 10.21608/aaogj.2025.391113.1016
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Author
Hanan Jawad email
Specialist of Obstetrics & Gynecology. Arbil - Iraq
Abstract
Background: Endometriosis of the abdominal wall (AWE) is a rare and often misdiagnosed condition that usually arises in surgical scars, especially after obstetric and gynecological procedures. Includes ectopic implantation of endometrial tissue in the abdominal wall, most common in the course of previous cesarean sections. AWE may manifest as a painful lump, often periodically painful, but in rare cases, it can appear with unusual features such as bleeding. Case presentation: We reported the case of 39-year-old woman gravida 7 para 4 and 3 miscarriages. who appeared on a painful mass that gradually enlarged in the lower abdominal wall, associated with intermittent bloody discharge from the site. The patient had a surgical history of four cesarean sections, the last of which occurred 7 years ago. A physical examination revealed a hard and thin lump under the skin near the former Pfannenstiel incision. Ultrasound and MRI have suggested the presence of a heterogeneous lesion consistent with endometriosis. Excisional biopsy was performed, and histopathological analysis confirmed the diagnosis of endometriosis Complete surgical removal with negative margins Is the treatment of choice and the symptoms disappeared completely. Discussion: AWE should be considered in the differential diagnosis of any painful lump in the abdominal wall, especially in women with a history of cesarean section or other pelvic surgeries. The unusual symptom of bleeding from the mass is uncommon but can occur due to superficial erosion of the lesion. Imaging is necessary for planning before treatment, but the final diagnosis is confirmed histologically.
Keywords
Endometriosis; Anterior abdominal wall; hemorrhagic mass
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