Giant Isthmocele With a Large, Degenerated, False Broad Ligament Fibroid and Its Diagnostic Dilemmas: The Use of the Halloween Sign.

The prevalence of isthmocele or caesarean scar niche is increasing nowadays. This is largely attributed to the increasing rate of caesarean deliveries globally, although the growing awareness among gynaecologists and assisted reproductive technology specialists may contribute to the more frequent diagnosis of isthmocele. Although the presenting complaints, diagnosis, and management of isthmocele are discussed extensively in the literature, this case of large isthmocele with a large degenerated false broad ligament myoma, which caused diagnostic dilemma both preoperatively and postoperatively, needs a special mention. This is one such case of large isthmocele rarely reported in perimenopausal women obscured by concomitant uterine pathology like degenerating large broad ligament fibroid. This also stresses the need for awareness and application of various techniques, such as the Halloween sign, for the proper diagnosis of the emerging but treatable complication of the most common surgery performed worldwide.