{"paper_id":"2ebc139d-4f72-4491-bddc-8759bcaf4a8c","body_text":"Abstract\nA 16-year-old girl presents to office with complaint of persistent abdominal and pelvic pain. She reports cramping and sharp pain that initially started prior to her menstrual cycle and lasted through the first 2–3 days of her menses, but now pain occurs daily. Her pain is most severe before and during her menses, which are regular. She has intermittent constipation and pain with bowel movements but no dysuria or increased frequency of urination. She is currently sexually active. She has missed multiple days of school due to her pain. Family history is significant for endometriosis and diabetes. Ibuprofen and an oral contraceptive pill provide no relief. Physical exam, as well as pelvic ultrasound, is normal. She undergoes a diagnostic laparoscopy, which reveals clear vesicular and red-flame-like lesions scattered along with posterior cul-de-sac and the bilateral uterosacral ligaments. Final pathology reveals endometrial stroma and glands confirming diagnosis of endometriosis.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nEmans SJ, Laufer MR. Emans, Laufer, Goldstein’s pediatric & adolescent gynecology. Chapter 13, Gynecologic pain: dysmenorrhea, acute and chronic pelvic pain, endometriosis, and premenstrual syndrome. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2012. p. 238–69.\nLaufer MR. Current approaches to optimizing the treatment of endometriosis in adolescents. Gynecol Obstet. Invest. 2008;66:19–27.\nACOG Committee Opinion: No 310. Endometriosis in adolescents. Obstet Gynecol. 2005;105:921.\nSchroeder B, Sanfillipo JS, Hertweck SP. Musculoskeletal pain in a pediatric and adolescent practice. J Pediatr Adolesc Gynecol. 2000;13:90.\nLaufer MR. Identification of clear vesicular lesions of atypical endometriosis: a new technique. Fertil Steril. 1997;68:739–40.\nGoldstein DP, De Cholnoky C, Emansi SJ. Adolescent endometriosis. J Adolesc Health Care. 1980;1:3741.\nJanssen EB, Rijkers AC, Hoppenbrouwers K, Meuleman C, D’Hooghe TM. Prevalence of endometriosis diagnosed by laparoscopy in adolescent with dysmenorrhea or chronic pelvic pain: a systematic review. Hum Reprod. Update. 2013;19:570–82.\nBrosens I, Gordts S, Benagiano G. Endometriosis in adolescents is a hidden, progressive and severe disease that deserves attention, not just compassion. Hum Reprod. 2013;28:2026–31.\nSanfillipo JS, Wakim NG, Schikler KN, Yussman MA. Endometriosis in association with uterine anomaly. Am J Obstet Gynecol. 1986;154:39–43.\nBallweg ML. Big picture of endometriosis helps provide guidance on approach to teens: comparative historical data show endo starting younger, is more severe. J Pediatr Adolesc Gynecol. 2003;16(Suppl 3):S21–6.\nYoost J, LaJoie SA, Hertweck P, Loveless M. Use of the levonorgestrel intrauterine system in adolescents with endometriosis. J Pediatr Adolesc Gynecol. 2013;26:120–4.\nDavies GD, Thillet E, Lindeman J. Clinical characteristics of adolescent endometriosis. J Adolesc Health. 1993;14:362–8.\nYeung P Jr, Sinervo K, Winer W, Albee RB Jr. Complete laparoscopic excision of endometriosis in teenagers: is postoperative hormonal suppression necessary? Fertil Steril. 2011;95:1909–12.\nTandoi I, Somigliana E, Riparini J, Ronzoni S, Vigano’ P, Candiani M. High rate of endometriosis recurrence in young women. J Pediatr Adolesc Gynecol. 2011;24:376–9.\nSuggested Educational Reading\nACOG Committee Opinion: No 310. Endometriosis in adolescents. Obstet Gynecol 2005;105:921.\nACOG Committee Opinion: No 114. Management of Endometriosis July 2010. Reaffirmed 2016.\nEmans SJ, Laufer MR. Emans, Laufer, Goldstein’s pediatric & adolescent gynecology. Chapter 13, Gynecologic pain: dysmenorrhea, acute and chronic pelvic pain, endometriosis, and premenstrual syndrome. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2012. p. 238–69.\nLaufer MR, Goitein L, Bush M, Cramer DW, Emans SJ. Prevalence of endometriosis in adolescent girls with chronic pelvic pain not responding to conventional therapy. J Pediatr Adolesc Gynecol. 1997;l10:199–202.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2018 Springer International Publishing AG\nAbout this chapter\nCite this chapter\nBonagura, E., Hertweck, S.P. (2018). Case of a Girl with Painful Periods, Pain with Bowel Movements, and Dyspareunia. In: Talib, H.J. (eds) Adolescent Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-319-66978-6_7\nDownload citation\nDOI: https://doi.org/10.1007/978-3-319-66978-6_7\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-319-66977-9\nOnline ISBN: 978-3-319-66978-6\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}