Abstract
Introduction: Perineal endometriosis is a rare entity which can be explained by direct implantation of endometriotic cells over the fresh episiotomy wound and subsequent development of scar endometriosis. Case Report: Present patient presented with pain at episiotomy site which is associated with menstruation. Examination during menstruation revealed reddish brown spots with blood oozing from the spots. Clinical diagnosis was confirmed by FNAC. Mass excised and sent for histopathological examination. Conclusion: Although diagnosis essentially remains clinical, preoperative evaluation with FNAC and endo-anal ultrasound can be performed. Wide local excision remains treatment of choice and follow up for recurrence is recommended. Histopathological examination is obligatory to exclude rare possibility of malignant changes.
Highlights
Perineal endometriosis is a rare entity which can be explained by direct implantation of endometriotic cells over the fresh episiotomy wound and subsequent development of scar endometriosis
Endometriosis is defined as the presence of functional endometrial tissue outside the uterine cavity [1]
A provisional diagnosis of episiotomy scar endometriosis was made which was subjected to FNAC
Summary
Endometriosis is defined as the presence of functional endometrial tissue outside the uterine cavity [1]. Both were normal vaginal delivery with episiotomy. There was no personal or family history of endometriosis Her menstrual cycles were regular; flow was normal and had mild pain in the abdomen as well as episiotomy scar. On examination her vital were stable and systemic examination revealed no abnormality. On local examination of perineum: overlying skin was healthy; an old healed right medio-lateral episiotomy scar was seen. A provisional diagnosis of episiotomy scar endometriosis was made which was subjected to FNAC.
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