The Overlooked Cause: Endometriosis Presenting as Perianal Fistula – Case Report

Charu Singh, Vidya Viswanathan, Sushama Gurwale, Nandita Wadhwa, Nishant Wadhwa
In: Journal of South Asian Federation of Obstetrics and Gynaecology · 2025 · vol. 17(3) , pp. 359–361 · doi:10.5005/jp-journals-10006-2700 · W4412732567
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Abstract

Endometriosis is defined by the presence of endometrial glands and stroma outside the uterine cavity.We are reporting a case of endometriosis which was identified in a sample sent as fistula tract.A 29-year-old female (P1L1) presented to the surgical outpatient department with complaints of bloody discharge, pain, and a mass-like lesion in the perianal region persisting for the past 6 months.She underwent fistulectomy for the same.Notably, she had a similar procedure performed 4 years ago.The patient also has a history of full-term vaginal delivery with episiotomy 1 year ago.Histopathological examination revealed fibromuscular stroma embedded with numerous endometrial glands along with stroma.Diagnosis of endometriosis in fistula-in-ano was rendered.This case highlights the importance of considering endometrial tissue in the differential diagnosis of fistulas in women.Accurate diagnosis relies on a combination of clinical evaluation, imaging techniques, and histopathological confirmation.

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endometriosis

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