A CASE REPORT BEYOND THE SCAR: DIAGNOSTIC COMPLEXITY IN A CASE OF POST-HYSTERECTOMY VAULT ENDOMETRIOSIS: A CASE REPORT
Authors
Apurva Anand ModakFiles
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Journal
Published in Vol. 67 No. 4 (2025) of Bombay Hospital Journal.
Bombay Hospital Journal (BHJ) is a peer-reviewed quarterly published Print and Online journal. It is an official Journal of Bombay Hospital institute of medical sciences. The aim of BHJ is to improve medical care by publishing sound scientific articles (both research and practice papers) and focusing on topics that are of great importance to its readership.
Editor-in-Chief- Dr Satish Vasant Khadilkar
About the JournalAbstract
ABSTRACT
Background: Vault endometriosis is a rare cause of post-hysterectomy vaginal bleeding and often presents years after surgery, posing a diagnostic challenge.
Case Presentation: A 50-year-old woman with a history of total laparoscopic hysterectomy with bilateral salpingectomy (TLH+BS) presented with brownish per vaginum spotting. Ultrasonography revealed a small vascular lesion at the vaginal vault. Laparoscopic excision of the vault nodule was performed. Histopathology confirmed vault endometriosis. Postoperatively, the patient was treated with a gonadotropin-releasing hormone (GnRH) agonist, with complete resolution of symptoms.
Conclusion: Vault endometriosis, though rare, should be considered in women presenting with post-hysterectomy vaginal bleeding. Laparoscopic excision with adjunctive hormonal therapy provides excellent outcomes.
Keywords: Vault endometriosis, Post-hysterectomy bleeding, Vaginal vault, Laparoscopy, GnRH agonist
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