CAESAREAN SCAR ENDOMETRIOSIS
External endometriosis is defined as the presence of endometrial tissue outside the uterus1-4. The most common location is within the pelvis and has been reported to occur in 8-15% of women of reproductive age, and 44% of women undergoing laparoscopy for non gynecological symptoms4-6. On the other hand extra pelvic endometriosis is a rare disorder and difficult to diagnose2-5. It can occur in any organ. Different sites for extra pelvic endometriosis are bladder, bowel, omentum, kidney, thoracic wall, lymph nodes, lungs, pleura, extremities, umbilicus, hernia sacs, nose, CNS and abdominal wall5-8. Abdominal wall endometriomas often develop in previous surgical scars but there is a case report of a spontaneous occurrence also2. Majority of the scar endometriosis have been reported after obstetrical or gynecological procedures such as cesarean delivery, hysterotomy, hysterectomy, episiotomy, and tubal ligations, but few case reports are following appendectomy, in the laparoscopic trocar tract, amniocentesis needle tract8. Scar endometriosis patients are often misdiagnosed and referred to the general surgeons because the clinical presentation suggests a surgical cause. In a study by Blanco et al3 the diagnosis was initially confused with inguinal hernia, incisional hernia and abdominal wall tumor.