Journal of

Case Reports and Images in Obstetrics and Gynecology

 
     
Case Report
 
Menstruation from the pfannenstial scar: A case of rare presentation of atypical endometriosis
Ahmad Akram Omar1, Mohd Shukri Othman2, Pek Sung Hoo3, Erinna Mohamad Zon4, Ahmad Amir Ismail1, Rahimah Abdul Rahim1, Nik Rafiza Afendi1, Adibah Ibrahim5
1Senior lecturer, Obstetrics and Gynaecology Department, School of Medical Science, University Sains Malaysia, Kota Bharu, Kelantan, Malaysia
2Professor, Obstetrics and Gynaecology Department, School of Medical Science, University Sains Malaysia, Kota Bharu, Kelantan, Malaysia
3Clinical lecturer, Obstetrics and Gynaecology Department, School of Medical Science, University Sains Malaysia, Kota Bharu, Kelantan, Malaysia
4Specialist trainee, Obstetrics and Gynaecology Department, School of Medical Science, University Sains Malaysia, Kota Bharu, Kelantan, Malaysia
5Associate Professor, Obstetrics and Gynaecology Department, School of Medical Science, University Sains Malaysia, Kota Bharu, Kelantan

Article ID: 100036Z08AO2018
doi: 10.5348/100036Z08AO2018CR

Corresponding Author:
Pek Sung Hoo,
Clinical lecturer, Obstetrics and Gynaecology Department,
School of Medical Science, University Sains Malaysia,
Kota Bharu, Kelantan, Malaysia

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How to cite this article
Omar AA, Othman MS, Hoo PS, Zon EM, Ismail AA, Rahim RA, Afendi NR. Menstruation from the pfannenstial scar: A case of rare presentation of atypical endometriosis. J Case Rep Images Obstet Gynecol 2018;4:100036Z08AO2018.


ABSTRACT

Introduction: Endometriosis is the presence of functioning endometrium (gland and stroma) in sites other than uterine mucosa, usually in the pelvis, causing dysmenorrhea, dyspareunia, menstrual irregularities, and infertility.

Case Report: A 27-year-old, had caesarean section 11 months ago presented to Obstetrics and Gynaecology clinic with cyclical bleeding from her surgical scar from ten months. She noted bleeding from the small nodule over the healed pfannenstial scar on day of her menses. Examination revealed a small reddish nodule 0.5 cmx0.5 cm, non-tender, with two blackish dots on it. Transabdominal ultrasound examination revealed that the nodule confined at the subcutaneous tissue, above the rectus. Diagnosis of scar endometriosis was made. She had wide local excision and recovered well. The histological examination was consistent with scar endometriosis.

Conclusion: Scar endometriosis is a very rare condition. Women in the reproductive age with swelling, pain and discharge at the scar following surgery should be suspected for scar endometriosis.

Keywords: Caesarean section, Endometriosis, Pfannenstial scar, Scar endometriosis


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Author Contributions
Ahmad Akram Omar – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Mohd Shukri Othman – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Pek Sung Hoo – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Erinna Mohamad Zon – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Ahmad Amir Ismail – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Rahimah Abdul Rahim – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Nik Rafiza Afendi – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Adibah Ibrahim – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Guarantor of Submission
The corresponding author is the guarantor of submission.
Source of Support
None
Consent Statement
Written informed consent was obtained from the patient for publication of this case report.
Conflict of Interest
Author declares no conflict of interest.
Copyright
© 2018 Ahmad Akram Omar et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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