Diagnostic Errors of Nodular Adenomyosis on the Example of a Clinical Case

A. A. Grigoryants, Victor Aksenenko
In: Ural Medical Journal · 2024 · vol. 23(6) , pp. 70–79 · doi:10.52420/umj.23.6.70 · W4405587205
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This clinical case analysis of nodular adenomyosis highlights diagnostic challenges and errors in patients with pelvic pain, emphasizing laparoscopy for diagnosis and treatment.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper analyzes a clinical case of a patient with nodular adenomyosis and a long course of chronic pelvic pain, using review of her medical history, prior examinations, hospitalizations, and treatments, followed by reassessment of available imaging. The authors report diagnostic errors and a resulting chronification of the process, with later re-evaluation of MRI scans leading to suspicion of nodular adenomyosis and subsequent laparoscopy, during which the diagnosis was confirmed; the lesion was removed and an anti-adhesion barrier used. The main limitation is that the evidence is derived from a single clinical case and the paper focuses on retrospective error analysis rather than systematic diagnostic performance. This paper is centrally about endometriosis—Relevance to endometriosis: it discusses chronic pelvic pain and includes literature references on endometriosis mechanisms and diagnosis, though the case and conclusions focus specifically on nodular adenomyosis rather than endometriosis.

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Abstract

Introduction. One of the less common forms of adenomyosis is the nodular type, characterized by localized foci composed of damaged endometrial glands and altered muscle and connective tissue fibers. Diagnosing nodular adenomyosis is oſten challenging, with the diagnosis frequently made intraoperatively or during histological examination. The purpose of the work . To analyze a clinical case involving a patient with nodular adenomyosis and a prolonged history of pelvic pain syndrome, aiming to identify diagnostic errors associated with this condition. Materials and methods. A clinical case was reviewed based on the patient’s medical history and treatments conducted prior to admission to the Gynecology Department of the Stavropol State Medical University Medical Center. Results and discussion . The chronology of diagnosis and treatment, along with an analysis of errors that led to the chronicity of the pathological process and subsequent deterioration in the patient’s quality of life and overall condition, is presented. This clinical case demonstrated that a gynecologist’s primary responsibility when examining patients with pelvic pain syndrome is to conduct detailed diagnostics. The authors re-evaluated the patient’s magnetic resonance imaging scans and suspected the diagnosis of “nodular adenomyosis”, which justified performing laparoscopy to confirm the condition. During the procedure, the diagnosis was confirmed, and the nodular adenomyosis was excised simultaneously. To prevent adhesion formation, an anti-adhesion barrier was applied. Conclusion . Laparoscopy is one of the most critical methods for diagnosing pelvic pain syndrome, as it enables early diagnosis, detailed examination of pelvic and abdominal organs, and the simultaneous execution of therapeutic interventions.

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Condition tags

adenomyosis

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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