Cyclical Bleeding from an Abdominal Wall Scar: A Clinical Case of Scar Endometriosis

Scar endometriosis is a rare type of extra pelvic endometriosis characterized by functional endometrial tissue in surgical wounds, often occurring after obstetric or gynecological surgeries. It typically presents as a painful lump near the surgical scar, with symptoms worsening during menstruation. We report a case of a 28-year-old multiparous woman who experienced cyclical pain and bleeding at the site of a previous tubal ligation for two years. Clinical examination showed a tender, nodular swelling with active bleeding during menses. Imaging revealed a vascular lesion near the rectus muscle, confirming scar endometriosis. A wide surgical excision was performed, and histopathology confirmed endometrial tissue in the scar. The patient's recovery was smooth, with no recurrence noted. This case underscores the need to recognize cyclical symptoms at surgical scars as important indicators of scar endometriosis, highlighting the significance of prompt diagnosis and treatment to prevent complications.