Episiotomy Scar Endometriosis: A Case Report and Review of Literature.

Anita Kumari, Poonam Singh, Bindu Sinha
In: Indian Journal of Case Reports · 2022 · pp. 62–64 · doi:10.32677/ijcr.v8i3.3319 · W4223569159
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This case report and literature review describes episiotomy scar endometriosis, presenting as a tender, cyclical nodule at the scar site, which is best treated with wide local excision.

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This case report and literature review describes extremely rare endometriosis occurring within an episiotomy scar in the perineum of a 30-year-old woman, presenting with perineal swelling and pain that increased during menstruation. Diagnosis was supported by clinical examination and ultrasonography, and wide local excision was performed with histopathological examination confirming endometriosis in the scar. The authors note the typical clinical triad of prior episiotomy, a tender nodule at the scar site, and cyclical pain, and emphasize that episiotomy scar endometriosis should be considered in the differential for painful perineal swelling. This paper is centrally about endometriosis—episiotomy scar endometriosis presenting as a tender perineal nodule with cyclical pain.

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Abstract

Abstract Background Endometriosis is defined as the presence and growth of endometrial tissue implants, outside the uterine cavity. It may be pelvic and extra-pelvic sites. Endometriosis in an episiotomy scar is extremely rare but can lead to significant morbidity in patients due to local infiltration. This condition usually presents with clinical triad of history of episiotomy, tender nodule at the scar site and cyclical pain. Case Presentation Here we report one such case of episiotomy scar endometriosis in the perineum of a 30 years young female (P1L1) which presented with swelling and pain in perineal region. The clinical examination and Ultrasonography (USG) corroborate with diagnosis of episiotomy scar endometriosis. Excision was done and histopathological examination confirmed the diagnosis. Conclusion Episiotomy scar endometriosis should always be kept in differential diagnosis when a lady presents with painful perineal swelling which increases during menstruation. This can be diagnosed with clinical and radiological examination. Wide local excision is the treatment of choice. Confirmation of the lesion can be done with histopathological examination. Keywords: Episiotomy scar endometriosis, perineal scar endometriosis, scar endometriosis
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Abstract

Background Endometriosis is defined as the presence and growth of endometrial tissue implants, outside the uterine cavity. It may be pelvic and extra-pelvic sites. Endometriosis in an episiotomy scar is extremely rare but can lead to significant morbidity in patients due to local infiltration. This condition usually presents with clinical triad of history of episiotomy, tender nodule at the scar site and cyclical pain. Case Presentation Here we report one such case of episiotomy scar endometriosis in the perineum of a 30 years young female (P1L1) which presented with swelling and pain in perineal region. The clinical examination and Ultrasonography (USG) corroborate with diagnosis of episiotomy scar endometriosis. Excision was done and histopathological examination confirmed the diagnosis.

Conclusion

Episiotomy scar endometriosis should always be kept in differential diagnosis when a lady presents with painful perineal swelling which increases during menstruation. This can be diagnosed with clinical and radiological examination. Wide local excision is the treatment of choice. Confirmation of the lesion can be done with histopathological examination.

Keywords

Episiotomy scar endometriosis, perineal scar endometriosis, scar endometriosis Downloads Downloads Published Issue Section License Copyright (c) 2022 ANITA KUMARI, Poonam Singh, Bindu Sinha This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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Condition tags

endometriosis

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