Acute abdominal pain in women of reproductive age: keys to suggest a complication of endometriosis

Juliette Coutureau, Caroline Mandoul, Cecile Verheyden, Cécile Verheyden, Ingrid Millet, Patrice Taourel
Insights into imaging · 2023 · vol. 14(1) , pp. 94 · doi:10.1186/s13244-023-01433-6 · PMID:37222834 · PMC10209382 · W4377941063
review OA: gold CC0 ⤵ 8 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review presents key imaging findings on MRI and CT that help diagnose acute abdominal complications of endometriosis, such as bowel or urinary tract obstruction and inflammation.

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

This pictorial review examines imaging findings for acute abdominal complications of endometriosis in women of reproductive age, focusing on how radiologists can recognize urgent presentations such as pelvic inflammatory disease, endometrioma superinfection, endometrioma rupture, and other mass-effect or inflammatory mechanisms. Across described scenarios, it highlights that MRI is the key modality for diagnosis, while CT can also diagnose disease in specific contexts (e.g., suggestive mildly enhanced infiltrative lesions, cystic masses with pelvic fat stranding, and MRI-defined loss of typical endometrioma signal features or characteristic ascites patterns). The paper notes major caveats including the lack of an established standard of care for infected endometriomas and limitations in differentiating entities based on clinical features alone because presentations can overlap with other acute gynecologic/infectious conditions. This paper is centrally about endometriosis — it provides an image-based overview of acute abdominal complications of endometriosis and their diagnostic imaging keys.

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Abstract

Although endometriosis is a common gynecological condition in women of reproductive age, a complication of endometriosis is rarely considered as the differential diagnosis of acute abdominal pain in that context. However, acute events in women with endometriosis can represent life-threatening conditions, which require emergent treatment and often surgical management. Mass effect of endometriotic implants can give rise to obstructive complications, specifically occurring in the bowel or in the urinary tract, while inflammatory mediators released by ectopic endometrial tissue can lead to inflammation of the surrounding tissues or to superinfection of the endometriotic implants. Magnetic resonance imaging is the best imaging modality to reach the diagnosis of endometriosis, but an accurate diagnosis is possible on computed tomography, especially in the presence of stellar, mildly enhanced, infiltrative lesions in suggestive areas. The aim of this pictorial review is to provide an image-based overview of key findings for the diagnosis of acute abdominal complications of endometriosis.

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Condition tags

endometriosis

Citation neighborhood

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.

References (94)

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europepmc
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License: CC0 · commercial use OK