Perineal scar endometriosis

S Shanmuga Jayanthan, G Shashikala, N Arathi
The Indian journal of radiology & imaging · 2019 · vol. 29(04) , pp. 457–461 · doi:10.4103/ijri.ijri_366_19 · PMID:31949353 · W2998698486
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This report details a rare case of endometriosis occurring in a perineal episiotomy scar, a condition diagnosed clinically and with MRI.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This paper reports a single case of perineal scar endometriosis arising in an episiotomy scar, describing its presentation and diagnostic workup at a high level. The authors note that extra-pelvic endometriosis most often occurs in surgical scar sites, and that episiotomy scar endometriosis can cause morbidity due to local infiltration, with diagnosis based on a history of episiotomy, a tender nodule, and cyclical pain supported by MRI for assessing deeper extension. A key limitation is that the report is a case description, not a comparative study, so generalizable evidence is not provided. This paper is centrally about endometriosis — it specifically focuses on perineal episiotomy scar endometriosis.

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Abstract

Endometriosis is defined as the presence of ectopic endometrial tissue outside the uterine cavity. It is a benign condition commonly observed in women of the reproductive age group. It can occur in both pelvic and extra-pelvic sites. Moreover, pelvic endometriosis is relatively common, as compared to extra-pelvic endometriosis. The most frequent site for pelvic endometriosis is ovary. It can also affect rectum, uterosacral ligaments, rectovaginal septum, urinary bladder. Extra-pelvic endometriosis is rare and when it occurs, does so more frequently in surgical scar sites, especially in caesarean section scar. Endometriosis in an episiotomy scar is extremely rare but can lead to significant morbidity in patients due to local infiltration. This condition can be diagnosed by the presence of the classical clinical triad of history of episiotomy, tender nodule at the scar site and cyclical pain. Magnetic resonance imaging (MRI) is a very useful imaging modality to diagnose and assess the deeper extension of the lesion. Herein, we report one such case of episiotomy scar endometriosis in the perineum.
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Abstract

Endometriosis is defined as the presence of ectopic endometrial tissue outside the uterine cavity. It is a benign condition commonly observed in women of the reproductive age group. It can occur in both pelvic and extra-pelvic sites. Moreover, pelvic endometriosis is relatively common, as compared to extra-pelvic endometriosis. The most frequent site for pelvic endometriosis is ovary. It can also affect rectum, uterosacral ligaments, rectovaginal septum, urinary bladder. Extra-pelvic endometriosis is rare and when it occurs, does so more frequently in surgical scar sites, especially in caesarean section scar. Endometriosis in an episiotomy scar is extremely rare but can lead to significant morbidity in patients due to local infiltration. This condition can be diagnosed by the presence of the classical clinical triad of history of episiotomy, tender nodule at the scar site and cyclical pain. Magnetic resonance imaging (MRI) is a very useful imaging modality to diagnose and assess the deeper extension of the lesion. Herein, we report one such case of episiotomy scar endometriosis in the perineum. Publication History Received: 18 September 2019 Accepted: 26 November 2019 Article published online: 21 July 2021 © 2019. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Private Ltd. A-12, Second Floor, Sector -2, NOIDA -201301, India -

References

- 1 Saloum NM, Qureshi S, Ibrahim SA, Alrashid A. A rare case report of endometriosis in an episiotomy scar without anal sphincter involvement. EC Gynaecol 2018; 7: 466-70 - 2 Francica G, Giardiello C, Angelone G, Cristiano S, Finelli R, Tramontano G. Abdominal wall endometriomas near cesarean delivery scars: Sonographic and color doppler findings in a series of 12 patients. J Ultrasound Med 2003; 22: 1041-7 - 3 Kamble VR, Gawande MS. Preoperative magnetic resonance evaluation of perineal endometriosis in episiotomy scar with anal sphincter involvement. J Med Cases 2014; 5: 298-301 - 4 Dadhwal V, Sharma A, Khoiwal K, Nakra T. Episiotomy scar endometriosis. Med J Armed Forces India 2018; 74: 297-9 - 5 Jain D. Perineal scar endometriosis: A comparison of two cases. BMJ Case Rep 2013; - 6 Stilley JA, Birt JA, Shape-Timms KL. Cellular and molecular basis for endometriosis associated infertility. 2012 349. 849-62 - 7 de Gauna BR, Rodriguez D, Cabré S, Callejo J. A case of endometriosis in episiotomy scar with anal sphincter involvement. Int J Clin Med 2011; 2: 624-6 - 8 Leite GK, Carvalho LF, Korkes H. Scar endometrioma following obstetric surgical incisions: Retrospective study on 33 cases and review of the literature. Sao Paulo Med J 2009; 127: 15-7 - 9 Sharma N, Khan DA, Jethani R, Baruah S, Dey B. Perineal endometriosis in an episiotomy scar: A case report and review of literature. Gynecol Obstet Case Rep 2018; 4: 66 - 10 Jeyaseelan S, Kwatra N. A rare case of episiotomy scar endometriosis. J Obstet Gynecol India 2016; 66: 654-5

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