Atypical Endometriosis: Its Presentation and Management

In: Chronic Pelvic Pain · 1998 · pp. 85–100 · doi:10.1007/978-1-4612-1752-7_6 · W1043389535
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AI-generated summary by claude@2026-06+body, 2026-06-13

This paper discusses endometriosis, describing it as a condition with varied presentation, diagnostic difficulty, treatment resistance, and recurrence, similar to a demon leaping from a head.

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This 1998 chapter discusses atypical presentations of endometriosis and frames the “demon” of varied symptoms, diagnostic difficulty, difficulties in isolating disease, treatment refractoriness, and recurrence, drawing on a broad literature base. It is largely a narrative synthesis focused on how endometriosis can appear in non-classical ways and on general approaches to its management, without presenting a new experimental study or quantitative results. A major limitation is that the content provides conceptual discussion rather than a standardized method or data-driven comparison of specific interventions. This paper is centrally about endometriosis — its focus is atypical presentation and management of endometriosis within the chronic pelvic pain context.

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Abstract

Jean Miro’s painting, head of a woman, accurately describes the dilemma patients and physicians face when dealing with endometriosis. The painting depicts a demon leaping from an abstract head; at times, endometriosis appears demonic because of its varied presentation, difficulty of diagnosis and isolation, refractoriness to treatment, and recurrence. Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

References

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Mathur S, Garza DE, Smith LF. Endometrial autoantigens eliciting immunoglobu-lin (Ig)G, IgA, and IgM responses in endometriosis. Fertil Steril 1990; 54: 56. Oosterlynck DJ, Cornillie FJ, Waer M, et al. Women with endometriosis show a defect in natural killer activity resulting in a decreased cytotoxicity in autologous endometrium. Fertil Steril 1991; 56: 45. Haney AF, Jenkins S, Weinberg JB. The stimulus responsible for the peritoneal fluid inflammation observed in infertile women with endometriosis. Fertil Steril 1991; 56: 408. Van der Linden PJQ, de Goeij AFPM, Dunselman GAJ, et al. Expression of integrins and E-cadherin in cells from menstrual effluent, endometrium, peritoneal fluid, peritoneum, and endometriosis. Fertil Steril 1994; 61: 85. Spuijroek MDEH, Dunselman GAJ, Menheere PPCA, et al. Early endometriosis invades the extracellular matrix. Fertil Steril 1992; 58: 929. Sillem M, Hahn U, Coddington CC III, et al. Ectopic growth of endometrium depends on its structural integrity and proteolytic activity in the cynomolgus monkey (Macaca fascicularis) model of endometriosis. Fertil Steril 1996; 66: 468. Oosterlynck DJ, Meuleman C, Sobis H, et al. Angiogenic activity of peritoneal fluid from women with endometriosis. Fertil Steril 1993; 59: 778. Jurgensen A, Mettler L, Volkov NI, et al. Proliferative activity of the endometrium throughout the menstrual cycle in infertile women with and without endometriosis. Fertil Steril 1996; 66: 369. McBean JH, Gibson M, Brumsted JR. The association of intrauterine filing defects on hysterosalpingogram with endometriosis. Fertil Steril 1996; 66: 522. Lessey BA, Castelbaum AJ, Sawin SW, et al. Aberrant integrin expression in the endometrium of women with endometriosis. J Clin Endocrinol Metal 1994; 79: 643. Konnickx PR, Meuleman C, Oosterlynck D, et al. Diagnosis of deep endometriosis by clinical examination during menstruation and plasma CA-125 concentration. Fertil Steril 1996; 65: 280. Koninckx PR, Martin DC. Deep endometriosis: a consequence of infiltration or retraction or possibly adenomyosis externa? Fertil Steril 1992; 58: 924. Donnez J, Nisolle M, Somes P, et al. Peritoneal endometriosis and “endometriotic” nodules of the rectovaginal septum are two different entities. Fertil Steril 1996; 66: 362. Murphy AA, Green WR, Bobbie D, et al. Unexpected endometriosis documented by scanning electron microscopy in visually normal peritoneum. Fertil Steril 1986; 46: 522. Redwine DB. Conservative laparoscopic excision of endometriosis by sharp dissection: life table analysis of reoperation and persistent or recurrent disease. Fertil Steril 1991; 56: 628. Namnoum AB, Hickman TN, Goodman SB, et al. Incidence of symptom recurrence after hysterectomy for endometriosis. Fertil Steril 1995; 64: 898. Metzger DA, Szpak CA, Haney AF. Histologic features associated with hormonal responsiveness of ectopic endometrium. Fertil Steril 1993; 59: 83. Nisole M, Casanas-Roux F, Wyns C, et al. Immunohistochemical analysis of estrogen and progesterone receptors in endometrium and peritoneal endometriosis: a new quantitative method. Fertil Steril 1994; 62: 751. Surrey ES, Halme J. Direct effects of medroxyprogesterone acetate, danazol, and leuprolide acetate on endometrial stromal cell proliferation in vitro. Fertil Steril 1992; 58: 273. Fedele L, Bianchi S, Bocciolone L, et al. Pain symptoms associated with endometriosis. Obstet Gynecol 1909 2; 70: 767. Vercellini P, Trespidi L, De Giorgi O, et al. Endometriosis and pelvic pain: relation to disease stage and localization. Fertil Steril 1996; 65: 299. Editor information Editors and Affiliations Rights and permissions Copyright information © 1998 Springer Science+Business Media New York About this chapter Cite this chapter Blackwell, R.E. (1998). Atypical Endometriosis: Its Presentation and Management. In: Blackwell, R.E., Olive, D.L. (eds) Chronic Pelvic Pain. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1752-7_6 Download citation DOI: https://doi.org/10.1007/978-1-4612-1752-7_6 Publisher Name: Springer, New York, NY Print ISBN: 978-1-4612-7265-6 Online ISBN: 978-1-4612-1752-7 eBook Packages: Springer Book Archive

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endometriosis

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