Endometriosis in Episiotomy Sar Involving Anal Sphincter.

K. Maeda; Mitsumasa Hashimoto; Hitoshi Katai; J. Koh; Osami Yamamoto; Y Hosoda; R. Nishino; Yoshimune Horibe

doi:10.3862/jcoloproctology.46.891

Endometriosis in Episiotomy Sar Involving Anal Sphincter.

K. Maeda, Mitsumasa Hashimoto, Hitoshi Katai, J. Koh, Osami Yamamoto, Y Hosoda, R. Nishino, Yoshimune Horibe

In: Nippon Daicho Komonbyo Gakkai Zasshi · 1993 · vol. 46(7) , pp. 891–894 · doi:10.3862/jcoloproctology.46.891 · W2313380801

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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-29 ⓘ

A case of endometriosis in an episiotomy scar involving the anal sphincter required tumor excision and sphincteroplasty, with literature review suggesting a single-stage proctoplasty is feasible.

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The paper reports a single 36-year-old woman with episiotomy-site endometriosis that extended into the anal sphincter after childbirth, presenting as a perineal lump that enlarged and caused swelling and pain around and after menstruation. After biopsy diagnosed perineal endometriosis, she received 6 months of hormonal therapy and then underwent tumor excision that included part of the external anal sphincter, followed by sphincter reconstruction. Histology confirmed ectopic endometriosis involving the sphincter, and the authors note that such cases are very rare and that complete excision may be required, enabling one-stage sphincter formation. The paper is centrally about endometriosis — specifically, anal sphincter–involving perineal (episiotomy scar) endometriosis.

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Abstract

分娩時の会陰切開創に発生し,肛門括約筋に及んだ異所性子宮内膜症に対し,腫瘍切除と肛門括約筋形成術を施行した1例を報告する.症例は36歳の女性で,24歳時に2児を出産した,その2年後,会陰部のしこりに気が付き,28歳頃より月経中と月経後に会陰部の膨隆と痛みを認め,6カ月前より硬結の増大を生じた.会陰切開創の一部に,径1.5cm大の腫瘤があり,生検にて,会陰部子宮内膜症と診断され,6カ月間ホルモン療法施行後手術を行った.外肛門括約筋の一部を含む腫瘤切除と括約筋形成術を行い,組織学的に括約筋に及んだ異所性子宮内膜症と診断された.会陰部子宮内膜症が肛門括約筋に及ぶ症例は,非常に稀であるが,肛門括約筋の合併切除を伴う腫瘤切除が必要であり,一期的に肛門形成術を行う術式が可能であると考えられた.本邦報告例26例も集計し,同時に報告する.

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肛門括約筋に及んだ会陰部子宮内膜症の1例 1993 年 46 巻 7 号 p. 891-894 詳細抄録分娩時の会陰切開創に発生し,肛門括約筋に及んだ異所性子宮内膜症に対し,腫瘍切除と肛門括約筋形成術を施行した1例を報告する.症例は36歳の女性で,24歳時に2児を出産した,その2年後,会陰部のしこりに気が付き,28歳頃より月経中と月経後に会陰部の膨隆と痛みを認め,6カ月前より硬結の増大を生じた.会陰切開創の一部に,径1.5cm大の腫瘤があり,生検にて,会陰部子宮内膜症と診断され,6カ月間ホルモン療法施行後手術を行った.外肛門括約筋の一部を含む腫瘤切除と括約筋形成術を行い,組織学的に括約筋に及んだ異所性子宮内膜症と診断された.会陰部子宮内膜症が肛門括約筋に及ぶ症例は,非常に稀であるが,肛門括約筋の合併切除を伴う腫瘤切除が必要であり,一期的に肛門形成術を行う術式が可能であると考えられた.本邦報告例26例も集計し,同時に報告する. © 日本大腸肛門病学会この記事はクリエイティブ・コモンズ [表示 - 非営利 - 改変禁止 4.0 国際]ライセンスの下に提供されています。 https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja

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