Endometriosis Anal. A Propósito de Dos Casos

Background: endometriosis is defined as the presence of endometrial tissue outside of the uterine cavity. Patients and method: two patients between 30 and 40 years old consulting for perianal lump of cyclic emergence associated with pain in that area. The study method for both cases was a 360o transrectal ultrasound, showing an hypoecogenic image in then anterolateral region, in contact with the external anal sphincter. A complete resection of the mass, the episiotomy scar and beams of the external anal sphincter was performed, with simultaneous plication. Anatomopathological examination confirmed the diagnosis. The follow-up periods were 15 and 84 months. There were no apparent postop complications or recurrence of the tumor in any of the cases. Discussion: the perianal localization is highly uncommon (0.3%) and even more, the sphincter involvement (0.18%). They usually appear after episiotomy or laceration during delivery. 360 ultrasound allows to evaluate the extent of the injury and the commitment of the sphincters. Wide resection of the endometrioma with normal tissue margins (between 0.5 - 1 cm) is the best choice for the cure of the disease, although it can cause incontinence by resection of the affected sphincter and may need a sphincteroplasty. Conclusion: perianal location endometriosis is a non-frequent condition with a difficult diagnosis. The treatment of choice is surgery. Including the full mass, with free margins and episiotomy scar.