Senior Resident, Department of obstetrics & Gynecology, AIIMS, Nagpur, India.
Assistant Professor, Department of obstetrics & Gynecology, AIIMS, Nagpur, India.
Trop Doct. 2024 Oct;54(4):386-388. doi: 10.1177/00494755241269192. Epub 2024 Aug 22.
We report a rare case of episiotomy site scar endometriosis manifested as painful perineal swelling near the anus for 2 years affecting daily routine activity, especially during menses. A 33-year-old female, para 2 with both vaginal deliveries with last child birth 8 years back. A 2.5 × 3 cm firm, tender nodule was present on the posterior vulva at the right mediolateral episiotomy site. Trans-perineal and trans-anal ultrasound scan was done, anal sphincter involvement was ruled out and the nodule was excised with free margins. histopathology confirmed the diagnosis of scar endometriosis. The key takeaway from this case is endometriosis can present after 8 years of vaginal delivery. The timely diagnosis and treatment is necessary as delay may cause anal sphincter involvement or malignant transformation.
我们报告了一例罕见的会阴切开部位瘢痕内异症病例，表现为肛门附近疼痛性会阴肿胀，持续 2 年，影响日常活动，尤其是在经期。患者为 33 岁女性，经阴道分娩 2 次，末次分娩距今 8 年。在右侧会阴侧切部位的会阴后外侧可见一个 2.5×3cm 的质硬、触痛结节。行经会阴和经肛门超声检查，排除肛门括约肌受累，切除结节并保证切缘无肿瘤。组织病理学证实为瘢痕内异症的诊断。本病例的主要收获是，阴道分娩 8 年后也可能出现内异症。及时诊断和治疗是必要的，因为延迟可能导致肛门括约肌受累或恶性转化。
