Deep pelvic endometriosis: a radiologist’s guide to key imaging features with clinical and histopathologic review

While endometriosis typically affects the ovaries, deep infiltrating endometriosis can affect the gastrointestinal tract, urinary tract, and deep pelvis, awareness of which is important for radiologists. Symptoms are nonspecific and can range from chronic abdominal and deep pelvic pain to nausea, vomiting, diarrhea, constipation, hematuria, and rectal bleeding. Ultrasound and computed tomography may show nonspecific soft-tissue density masses causing bowel obstruction and hydronephrosis. This constellation of presenting symptoms and imaging evidence is easily mistaken for other pathologies including infectious gastroenteritis, diverticulitis, appendicitis, and malignancy, which may lead to unnecessary surgery or mismanagement. With this, deep pelvic endometriosis should be considered in the differential diagnosis in a female patient of reproductive age who presents with such atypical symptoms, and further work up with magnetic resonance imaging is imperative for accurate diagnosis, treatment selection, and preoperative planning. Similar content being viewed by others

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The authors acknowledge the assistance of Eric J. Gray and Sonia Watson, Ph.D., for editing the manuscript and Christopher M. Brown for illustration design. Author information Authors and Affiliations Corresponding author Ethics declarations Funding No funding was received for this study. Conflicts of interest The authors declare that they have no conflict of interest. Ethical approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent Statement of informed consent was not applicable since the manuscript does not contain any patient data. Rights and permissions About this article Cite this article Darvishzadeh, A., McEachern, W., Lee, T.K. et al. Deep pelvic endometriosis: a radiologist’s guide to key imaging features with clinical and histopathologic review. Abdom Radiol 41, 2380–2400 (2016). https://doi.org/10.1007/s00261-016-0956-8 Published: Issue date: DOI: https://doi.org/10.1007/s00261-016-0956-8