Epizyotomi skarında gelişen endometriozis: Olgu sunumu

Recep Erin, Yeşim Bayoğlu Tekın, Kübra Baki Erin, Deniz Kulaksız
2020 · vol. 2(2) , pp. 80–83 · W3096193869
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A 35-year-old woman with perineal pain and a mass at her episiotomy scar was diagnosed with perineal endometriosis via histopathology following surgical excision.

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This case report describes a 35-year-old woman presenting with a five-year history of cyclical pain and swelling localized to a mediolateral episiotomy scar. Physical examination identified a semi-mobile, soft mass measuring 2.5 cm within the scar tissue, which was subsequently removed via surgical excision. Histopathological analysis confirmed the diagnosis of perineal endometriosis arising in the scar site. The authors conclude that surgical excision is an effective treatment and recommend considering this condition in the differential diagnosis for patients with similar symptoms. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Endometriosis refers to the presence of functional endometrial tissue outside the uterine cavity.The most common sites of endometriosis are the ovaries and visceral peritoneal surfaces.Endometriosis may also occur in extrapelvic sites and abdominal or episiotomy scar due to hysterectomy, cesarean section and vaginal birth.Perineal endometriosis is defined as the presence of endometrial tissues in the perineum.A-35-year old, G2P2 woman with a history of two vaginal births was admitted to our hospital with a complaint of perineal pain and mass.She has been symptomatic for five years following her last vaginal birth.Her pain was located in her mediolateral episiotomy scar.She reported worsening pain during menstruation.The examination revealed a semi-mobile, soft mass measuring 2.5x2x2 cm at the episiotomy scar.Surgical excision of the mass was performed, and histopathology revealed perineal endometriosis.Surgical excision of the endometriotic implant is an excellent option to treat perineal endometriosis.Perineal endometriosis should be kept in mind in patients with a perineal mass and pain.
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Abstract

Fonksiyonel endometrial dokunun uterin kavite dışında bulunmasına endometriozis denir. Over ve viseral peritoneal yüzeyler en sık tutulan yerlerdir. Ekstrapelvik bölgelerde özellikle sezaryen ve histerektomiyi takiben skar bölgelerinde ve epizyotomili vajinal doğum sonrasında perineal endometriozis görülebilir. Perineal bölgede endometrial dokunun bulunması perineal endometriozis olarak adlandırılır. Otuz beş yaşında, G2P2, vajinal yolla iki doğumu olan kadın hasta, perineal bölgede şişlik ve ağrı şikayetiyle hastanemize başvurdu. Semptomları beş yıldır mediolateral epizyotomi skarına uygun yerde, mentrüasyonla artan ağrı şeklinde idi. Muayenede skar hattında 2.5x2x 2 cm boyutlarında, semi-mobil yumuşak kıvamda kitle tespit edildi. Perineal kitle cerrahi olarak çıkartıldı ve patoloji sonucu endometriozis olarak rapor edildi. Perineal endometriozis tedavisinde cerrahi eksizyon iyi bir tedavi alternatifidir. Perineal endometriozis bu bölgede kitle ve ağrı şikayeti olan hastalarda ayırıcı tanıda düşünülmelidir.

Keywords

References - Eskenazi B, Warner ML. Epidemiology of endometriosis. Obstet Gynecol Clin North Am 1997; 24:235-258. - Jubanyik KJ, Comite F. Extrapelvic endometriosis. Obstet Gynecol Clin North Am 1997;24:411-440. - Chatterjee SK. Scar endometriosis: a clinicopathologic study of 17 cases. Obstet Gynecol 1980; 56:81-84. - Christos S, Paul Z, Nikolaos M, Konstantinos P, Lambros S, Alexandros M. Abdominal wall endometrioma mimicking an incarcerated hernia: a case report. Int J General Med 2012; 5:569-571. - Horton J, DeZee K, Ahnfeldt E, Wagner M. Abdominal wall endometriosis: a surgeon’s perspective and review of 445 cases. Am J Surg 2008; 196:207-212. - Bektas H, Bilsel Y, Sari Y, et al. Abdominal wall endometrioma; a 10 year experience and brief review of the literature. J Surg Res 2010; 164:77. - Wang HB, Zhu L, Lang JH, et al. Clinical analysis of 30 patients with perineal endometriosis. Zhonghua Yi Xue Za Zhi 2007; 87:1181-1183. - Rocío V, Jose L, Maria R, et al. Endometriosis node in Gynaecologic scars: A study of 17 patients and the diagnostic considerations in clinical experience in tertiary care center. BMC Womens Health 2015; 15:13-18. Details Primary Language Turkish Subjects Obstetrics and Gynaecology Journal Section Case Report Authors Recep Erin * 0000-0002-9488-5414 Türkiye Yeşim Bayoğlu Tekin Türkiye Kübra Baki Erin This is me 0000-0002-6626-1735 Türkiye Deniz Kulaksız This is me Türkiye Publication Date June 29, 2020 Submission Date February 27, 2020 Acceptance Date June 7, 2020 Published in Issue Year 2020 Volume: 2 Number: 2

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