What is endometriosis?

Updated: May 10, 2021
  • Author: Turandot Saul, MD; Chief Editor: Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE  more...
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Endometriosis is a gynecologic disorder that is frequently encountered in the emergency department (ED) as well as in the outpatient setting. Because it is enigmatic, endometriosis can present as a diagnostic and therapeutic challenge for emergency physicians in their approach to the female patient with pelvic pain. [1, 2, 3]

Prior to ascribing a patient's abdominal or pelvic pain to endometriosis, the clinician should consider other important causes of such pain, including ectopic pregnancy, pelvic infection, and ovarian torsion. Patients may also have concomitant endometriosis and inflammatory bowel disease (stricturing Crohn disease). [4]

The most common sites of involvement in endometriosis, as seen on laparoscopic examination, are as follows, in descending order:

  • Ovaries

  • Posterior cul-de-sac

  • Broad ligament

  • Uterosacral ligament

  • Rectosigmoid colon

  • Bladder

  • Distal ureter

Cases have been reported of extrapelvic involvement in virtually every other organ system including the central nervous system (CNS), lungs, pleura, kidney, and bladder. The gastrointestinal (GI) tract is the most common extrapelvic site of endometriosis, and symptoms include bowel obstruction, rectal bleeding, and constipation.

Go to Endometriosis for complete information on this topic.

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