Use of anal endosonography in diagnosis of endometriosis of the external anal sphincter

Bacher H, H Bacher, Heinz Bacher, W. Schweiger, Schweiger W, Cerwenka H, Herwig Cerwenka, H Cerwenka, Hans-Jörg Mischinger, H J Mischinger, Mischinger HJ
Diseases of the colon and rectum · 1999 · vol. 42(5) , pp. 680–682 · doi:10.1007/bf02234150 · PMID:10344694 · W2069632069
article OA: closed CC0 ⤵ 16 in-corpus citations
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-11 ⓘ

Anal endosonography accurately located an endometriotic lesion in the external anal sphincter, proving essential for diagnosis when other methods were inconclusive.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-14 · read from full text ⓘ

This case report examines a 24-year-old female with perianal endometriosis located in the external anal sphincter, highlighting the diagnostic utility of anal endosonography. The authors utilized preoperative and intraoperative imaging to precisely localize the lesion when standard history, digital examination, and proctoscopy proved inconclusive. They argue that surgical excision is superior to hormonal suppression for this specific presentation to preserve sphincter architecture and obtain necessary histological confirmation to rule out malignancy. This paper is centrally about endometriosis — specifically the diagnosis and surgical management of rare extragenital lesions involving the external anal sphincter.

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Abstract

PURPOSE: Perianal endometriosis is an infrequent form of extragenital endometriosis and is usually situated in episiotomy scars. METHODS: We report a rare case involving the external anal sphincter in a 24 year-old female. The precise anatomical location of the endometriotic lesion was confirmed using preoperative and intraoperative anal endosonography. CONCLUSION: We believe this procedure to be essential when history, digital examination, and proctoscopy are not conclusive in the differential diagnosis of perianal pain or mass. Although hormonal suppression often is the therapy of choice in extrapelvic endometriosis, we think surgical excision, respecting the anatomical fiber architecture of the anal sphincter, is the best treatment for perianal endometriosis. Surgical excision is required for histological diagnosis, which is imperative in view of the albeit rare development of malignancy in extragenital endometriosis.
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Methods

We report a rare case involving the external anal sphincter in a 24 year-old female. The precise anatomical location of the endometriotic lesion was confirmed using preoperative and intraoperative anal endosonography.

Conclusion

We believe this procedure to be essential when history, digital examination, and proctoscopy are not conclusive in the differential diagnosis of perianal pain or mass. Although hormonal suppression often is the therapy of choice in extrapelvic endometriosis, we think surgical excision, respecting the anatomical fiber architecture of the anal sphincter, is the best treatment for perianal endometriosis. Surgical excision is required for histological diagnosis, which is imperative in view of the albeit rare development of malignancy in extragenital endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Anal Canal Endometriosis Endosonography Adult Anal Canal Anal Canal Anal Canal Diagnosis, Differential Endometriosis Endometriosis Endometriosis Female Humans

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (14)

Cited by (16)

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