Rare but there:
endometriosis after C-section
NEW YORK, Apr 13 (Reuters Health)
-- In rare cases, women who have had a cesarean section may
end up with endometriosis in their surgical scar tissue,
sometimes years after the operation, according to a
report.
Endometriosis is a condition in
which bits of the lining of the uterus end up in parts of
the body they shouldn't be. The misplaced tissue can then
wax and wane with a woman's monthly cycle, causing bleeding,
irritation and other health problems.
Many general surgeons fail to
properly diagnose endometriosis in surgical scars (known as
incisional endometriosis), according to a report in the
April issue of the Journal of the American College of
Surgeons.
Drs. Raminder Nirula and Gregory C.
Greaney, from Santa Barbara Cottage Hospital in California,
reviewed the cases of 10 general surgery patients who were
diagnosed with incisional endometriosis between January 1990
and December 1998. The disease often manifests as a
slow-growing, painful lump at the edge of a surgical scar.
Two out of 10 women reported that the lump changed
characteristics with their menstrual cycle.
The condition was correctly
diagnosed in only two cases, the researchers report. Often
the lump was initially misdiagnosed as a cyst,
incision-related hernia, and in one case, breast cancer that
had spread from another part of the body. The women ranged
in age from 27 to 41 and experienced symptoms anywhere from
3 months to 10 years. The symptoms began from 1 to 7 years
after the cesarean.
With the proper diagnosis, the
growths, which were an average of 3 centimeters (or just
over 1 inch) in size, were surgically removed. The study is
the "largest series in the general surgery literature to
date, which underscores our under-appreciation of this
disease," the authors write.
SOURCE: Journal of the American
College of Surgeons 2000;190:404-407.
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