{"paper_id":"63aa04ac-1cbc-4dfb-95a9-f8838eeb1773","body_text":"Abstract\nBackground\nThe 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.\nMethods\nFour patients were evaluated by transperineal and high-resolution three-dimensional endoanal ultrasonography.\nResults\nIn 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.\nConclusions\nUltrasonographic findings of anal endometriosis are characteristics and may allow accurate preoperative staging of the disease.\nReferences\nAllaire C (2006) Endometriosis and infertility: a review. J Reprod Med 51:164–168\nTreloar SA, Wicks J, Nyholt DR et al (2005) Genome wide linkage study in 1.176 affected sister pair families identifies a significant susceptibility locus for endometriosis on chromosome 10q26. Am J Hum Genet 3:365–376\nBenagiano G, Brosens I (1991) The history of endometriosis: identifying the disease. Hum Reprod 6:963–968\nRiedel HH, Semm K (1982) Extragenital endometriosis and sterility-clinical experiences with a 3-step-therapy. Prog Clin Biol Res 112:187–194\nKanellos I, Kelpis T, Zaraboukas T, Betsis D (2001) Perineal endometriosis in episiotomy scar with anal sphincter involvement. 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Soc Obstet Gynaecol Can 32(Suppl 2):1–33\nConflict of interest\nNone.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nKołodziejczak, M., Sudoł-Szopińska, I., Santoro, G.A. et al. Ultrasonographic evaluation of anal endometriosis: report of four cases. Tech Coloproctol 18, 1099–1104 (2014). https://doi.org/10.1007/s10151-014-1176-2\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s10151-014-1176-2","source_license":"CC0","license_restricted":false}