Kołodziejczak M, Sudoł-Szopińska I, Santoro G A, Bielecki K, Wiączek A
Department of General Surgery, Sub-Department of Proctology, Hospital at Solec, 00-382, Warsaw, Poland.
Tech Coloproctol. 2014 Nov;18(11):1099-104. doi: 10.1007/s10151-014-1176-2. Epub 2014 Jun 11.
The presence of endometriosis in the anal canal and perianal tissues is rare and difficult to suspect at clinical examination. We report our experience with preoperative ultrasound evaluation of four cases of anal endometriosis.
Four patients were evaluated by transperineal and high-resolution three-dimensional endoanal ultrasonography.
In 3 of 4 women, the lesions involved old episiotomy scars. Anal endometriosis appeared as hypoechoic cystic lesions with areas of microcalcification, not well delimited and highly vascularized. The lesions either involved the anal sphincter (n = 2, one within the rectovaginal septum) or were localized superficially in the ischiorectal space (n = 2). Surgery and pathologic exam confirmed the ultrasonographic findings.
Ultrasonographic findings of anal endometriosis are characteristics and may allow accurate preoperative staging of the disease.
肛管和肛周组织中的子宫内膜异位症较为罕见，在临床检查时很难怀疑到。我们报告4例肛管子宫内膜异位症术前超声评估的经验。
对4例患者进行经会阴和高分辨率三维肛管超声检查。
4名女性中有3名患者的病变累及陈旧性会阴切开术瘢痕。肛管子宫内膜异位症表现为低回声囊性病变，伴有微钙化区域，边界不清且血管丰富。病变累及肛门括约肌（n = 2，其中1例位于直肠阴道隔内）或浅表位于坐骨直肠窝（n = 2）。手术和病理检查证实了超声检查结果。
肛管子宫内膜异位症的超声表现具有特征性，可能有助于对该病进行准确的术前分期。
