Perineal scar endometriosis

S Shanmuga Jayanthan, G Shashikala, N Arathi
The Indian journal of radiology & imaging · 2019 · vol. 29(04) , pp. 457–461 · doi:10.4103/ijri.ijri_366_19 · PMID:31949353 · PMC6958888 · W2998698486
article OA: gold CC0 ⤵ 13 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This report details a rare case of endometriosis occurring in a perineal episiotomy scar, a condition diagnosed clinically and with MRI.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This paper reports a single case of perineal scar endometriosis arising in an episiotomy scar, describing its presentation and diagnostic workup at a high level. The authors note that extra-pelvic endometriosis most often occurs in surgical scar sites, and that episiotomy scar endometriosis can cause morbidity due to local infiltration, with diagnosis based on a history of episiotomy, a tender nodule, and cyclical pain supported by MRI for assessing deeper extension. A key limitation is that the report is a case description, not a comparative study, so generalizable evidence is not provided. This paper is centrally about endometriosis — it specifically focuses on perineal episiotomy scar endometriosis.

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Abstract

Endometriosis is defined as the presence of ectopic endometrial tissue outside the uterine cavity. It is a benign condition commonly observed in women of the reproductive age group. It can occur in both pelvic and extra-pelvic sites. Moreover, pelvic endometriosis is relatively common, as compared to extra-pelvic endometriosis. The most frequent site for pelvic endometriosis is ovary. It can also affect rectum, uterosacral ligaments, rectovaginal septum, urinary bladder. Extra-pelvic endometriosis is rare and when it occurs, does so more frequently in surgical scar sites, especially in caesarean section scar. Endometriosis in an episiotomy scar is extremely rare but can lead to significant morbidity in patients due to local infiltration. This condition can be diagnosed by the presence of the classical clinical triad of history of episiotomy, tender nodule at the scar site and cyclical pain. Magnetic resonance imaging (MRI) is a very useful imaging modality to diagnose and assess the deeper extension of the lesion. Herein, we report one such case of episiotomy scar endometriosis in the perineum.

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endometriosis

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