Large bowel-to-pelvic sidewall adhesions associated with chronic pelvic pain

Keltz MD, M D Keltz, Martin D. Keltz, Peck L, L Peck, Lanford Peck, Susan Liu, Liu S, S Liu, Kim AH, Alexis H. Kim, A H Kim, Arici A, A Arici, Aydın Arıcı, D L Olive, Olive DL, David L. Olive
The Journal of the American Association of Gynecologic Laparoscopists · 1995 · vol. 3(1) , pp. 55–59 · doi:10.1016/s1074-3804(05)80137-9 · PMID:9050617 · W2083584517
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that colon-to-pelvic sidewall adhesions are highly prevalent in women with chronic pelvic pain, unlike in control groups, and are often associated with endometriosis.

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Abstract

STUDY OBJECTIVES: To assess retrospectively the prevalence of colon-to-pelvic sidewall adhesions associated with pelvic pain or pelvic endometriosis, and to evaluate prospectively their prevalence compared with controls. DESIGN: A retrospective review of all patients undergoing laparoscopy for chronic pelvic pain between August 1992 and September 1993; and abased on a power analysis, a prospective comparison of women undergoing laparoscopy for chronic pelvic pain with those undergoing laparoscopy for tubal sterilization between October 1994 and December 1995. SETTING: A university-associated teaching hospital. PATIENTS: Fifty women in the retrospective portion, and 30 women (15 in each group) in the prospective portion. MEASUREMENTS AND MAIN RESULTS: Of the 50 women undergoing laparoscopy for pelvic pain, 47 (94%) had either right- or left-sided colon-to-sidewall adhesions, and these adhesions were more common than any other type of intraabdominal adhesion, 94% versus 58%. Thirty-eight (76%) of these women had visual and 25 (50%) histologic evidence of endometriosis. The prospective study revealed that women with pelvic pain had a higher rate of colon-to-sidewall adhesions than controls (93.3% vs 13.3%) and a correspondingly higher rate of visualized endometriosis (73.3% vs 6. 7%). Right-sided paracolic adhesions were both more common than left-sided adhesions (87.7% vs. 46.7%) and were more often extensive than minimal (46.7% vs 6.7%). CONCLUSIONS: Colon-to-sidewall adhesions occur in the majority of patients with chronic pain, whereas they are an uncommon finding in the general population. The lateral gutters are dependent regions of the abdominal cavity that are susceptible to the spread of peritoneal endometriosis or other inflammatory processes, and should be evaluated at diagnostic laparoscopy for chronic pelvic pain.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Colonic Diseases Endometriosis Pelvic Pain Peritoneal Diseases Chronic Disease Colonic Diseases Colonic Diseases Colonic Diseases Diagnosis, Differential Endometriosis Endometriosis Endometriosis Female Humans Incidence Laparoscopy Pelvic Pain Pelvic Pain Peritoneal Diseases Peritoneal Diseases

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References (13)

Cited by (6)

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