ENDOMETRIOMA OF THE TERMINAL ILEUM, APPENDIX AND CECUM

Since Sampson's1exhaustive article on perforative hemorrhagic (chocolate) cysts of the ovary, one finds from time to time many and varied evidences of endometriosis. I have seen several such cases2in which the appearance of the uterus closely resembles a leiomyoma, but in which there are many firm dense adhesions to the ovaries, pelvic wall, rectum and sigmoid. In these cases, when trying to arrive at a definite diagnosis, there has always been one definite symptom of which all the patients have complained, pain in the rectum preceding and often accompanying defecation. The case I shall describe is, I think, unique in that there has never been any menstrual disturbance, and the patient has always been considered a strong, healthy member of her sex. REPORT OF A CASE Dr. Donald MacGillivray asked me to see a maiden lady, aged 38, on the evening of March 16, 1927. The