08/05/2025
Case report /ڕاپۆرتی کەیس/ تقرير حالة/
https://www.researchgate.net/publication/391526853_Case_report_Abdominal_Wall_Endometriosis_Presenting_as_a_Bloody_Mass_in_a_Patient_with_a_History_of_Four_Cesarean_Section
كوردي #عربي #انكليزي #
دیواری سک ئیندۆمێتریۆزی دەرکەوتن وەک بارستەیەکی خوێناوی لە نەخۆشێکدا کە تووشی...
مێژووی چوار نەشتەرگەری قيصرية
تا
دکتۆر حنان جواد كاظم
پسپۆڕی باڵا لە بواری منداڵبوون و ئافرەتان
پسپۆڕی لاوەکی لە نەزۆکی، ART و ئەندازیاری بایۆلۆجی، بایۆتەکنەلۆژیا و توێژینەوە لەسەر بنەمای مرۆڤ لە IVF
ئەندام لە بەشی دڵنیایی جۆری لە ئەنجومەنی باڵای فەزایی پزیشکی کوردستان\ کوردستان عێراق
بطانة الرحم المهاجرة في جدار البطن يظهر على شكل كتلة دموية لدى مريضة لديها تاريخ من أربع عمليات قيصرية
بقلم
د. حنان جواد كاظم
أخصائية في أمراض النساء والتوليد
اختصاص دقيق
في العقم، وتقنيات الإنجاب المساعدة، والهندسة الحيوية، والتكنولوجيا الحيوية، والبحوث البشرية في مجال أطفال الأنابيب
عضو في قسم ضمان الجودة في المجلس الأعلى للتخصصات الطبية في كردستان - كردستان العراق
Abdominal Wall Endometriosis Presenting as a Bloody Mass in a Patient with a
History of Four Cesarean Sections
by
Dr. Hanan Jawad Kadhim
Senior specialist in obstetrics and gynecology
sub-specialist in infertility, ART and bioengineering , biotechnology and human based research in IVF
member in the department of quality assurance at Kurdistan higher council of medical spatiality\ Kurdistan Iraq
Abstract:
I report the case of 39-year-old married female, gravida 7 para 4 ( all were delivered by cesarean section ) last one 7 years ago and 3 miscarriages.
She presented to me at her 1st visit at 30th of November 2024 with sever chronic and cyclical abdominal pain with painful, bloody mass in the abdominal wall and menorrhagia
The lesion exhibited cyclical changes with me**es and was associated with elevated serum estrogen levels. and CA125
A thorough clinical evaluation, imaging studies including ultrasound and CT scan, as well as hormonal assays, led to the diagnosis of abdominal wall endometriosis.
Introduction:
Endometriosis is defined as the presence of functional endometrial tissue outside the uterine cavity.
Cesarean scar endometriosis is a rare complication typically it affecting less than 1% of women who have had a cesarean section
It occurs when endometrial tissue, grows in the scar tissue from the cesarean section.
The exact cause of CSE is unknown, but it is thought to be related to the surgical procedure itself.
During a cesarean section, the uterus is opened and there is a risk of endometrial tissue being implanted in the abdominal wall. This tissue can then grow and cause this dramatic condition.
Here, I describe a rare presentation of abdominal wall endometriosis forming a bloody, cyclically active mass in a cesarean section scar.
Case Presentation: Patient Profile:
- Age: 39 years
- Gravida 7, Para 4, miscarriage 3
- Past surgical history: 4 lower segment cesarean sections
Chief Complaint:
39 y old women she presented to me at her 1st visit at 30th of November 2024 with sever chronic and cyclical abdominal pain and progressively enlarging, painful mass on the anterior abdominal wall with periodic bloody discharge from the overlying skin, exacerbated during menstruation with heavy menstrual period .
Clinical Examination:
- Vital signs: BP : 100\60 mm.hg PR: 110 b\m
Temp.: 36,4 c
- Local exam:
A firm, tender, palpable lower abdominal mass approximately 8 x 7 cm located near the previous cesarean scar with skin involvement showing a bloody discharge. with cauliflower hyperpigmented skin lesion that is bleeding to touch.
She complains of irregular menstrual cycle and menorrhagia. She was irritable, confused and worried regarding her condition.
Investigations:
1. Laboratory Findings:
CBC: anemic , Hg 9.3 mg\dl
Serum Estradiol: Elevated 182.2.pg\ml
CA-125: at 30-11-2024 which is the date of her 1st visit,
was highly elevated, 137.3 u\ml normal range was
