{"paper_id":"109ba7df-950e-4b96-96fd-bd553288916a","body_text":"Abstract\nWe here present a lady patient of perianal firm and tender lump with pre-menstrual exacerbation of pain that occurred after surgery for anal fissure during active menstruation which we believe is on account of endometrium implantation resulting into endometriosis. A 32-year-old woman presented with pain and mass in the anus 3 months after surgery for anal fissure. On examination, a firm swelling of 2 × 2 cm was felt extending from 7 to 10 o’clock position in the perianal area which was extremely tender. Detailed clinical history revealed exacerbation of pain before and after each menstrual cycle for the last 2 months. An incisional biopsy confirmed the diagnosis of endometrioma and following complete excision cured the condition. This is the first case report of such an incidence where surgical wound inoculation of menstrual endometrial tissue is in the perineal region. In our research with PubMed, we realized that there are no cases other than ours in the literature. We think that if surgeons abstain from perianal intervention to patients having identified endometrioma when the patient is in menstruation, the risk of occurrence of perianal endometrioma is decreased.\nSimilar content being viewed by others\nReferences\nZhu L, Chen N, Lang J (2012) Diagnosis and treatment of perineal endometriosis. In: Chaudhury K, Chakravarty B (eds) Endometriosis - basic concepts and current research trends. In Tech, Hampshire, pp 53–64\nXu S, Wang W, Sun LP (2020) Comparison of clear cell carcinoma and benign endometriosis in episiotomy scar - two cases report and literature review. BMC Womens Health 20(1):11\nDadhwal V, Sharma A, Khoiwal K, Nakra T (2018) Episiotomy scar endometriosis. Med J Armed Forces India 74(3):297–299\nBarlas D, Bozkurt S, Kaya MA, Çelik F (2010) Scar endometriosis in the rectus abdominis muscle. Ulus Travma Acil Cerrahi Derg 16(4):371–372\nRayatt S, Wilson G (1999) Re: Endometrioma of the abdominal wall following combined abdominoplasty and hysterectomy: case report and review of the literature. Ann PlastSurg 42:110\nJain D (2013) Perineal scar endometriosis: a comparison of two cases. BMJ Case Rep. https://doi.org/10.1136/bcr-2013-010051\nKołodziejczak M, Sudoł-Szopińska I, Santoro GA, Bielecki K, Wiączek A (2014) Ultrasonographic evaluation of anal endometriziosis: report of four cases. Tech Coloproctol. 18(11):1099–104\nTanbo T, Fedorcsak P (2017) Endometriosis-associated infertility: aspects of pathophysiological mechanisms and treatment options. Acta Obstet Gynecol Scand 96(6):659–667\nSingh MM (2001) Centchroman, a selective estrogen receptor modulator, as a contraceptive and for the management of hormone-related clinical disorders. Med Res Rev 21(4):302–347\nWatanabe M, Kamiyama G, Uamazaki K, Hiratsuka K, Takata M, Tsunoda A et al (2003) Anal endosonography in the diagnosis and management of perianal endometriosis: report of a case. Surg Today 33:630–632\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nCompeting interests\nThe authors declare no competing interests.\nAdditional information\nPublisher’s note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nKoca, B., Yildirim, M. Beware of Anal Fissure Surgery During Menstruation: Endometrium Inoculation. Indian J Surg 83, 1056–1058 (2021). https://doi.org/10.1007/s12262-021-02990-0\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s12262-021-02990-0","source_license":"CC0","license_restricted":false}