Gross visualization of endometrial implants remains the definitive method of diagnosis. In this era of minimally invasive surgery, laparoscopy is the procedure of choice. Laparotomy can be another method of diagnosis. This is usually performed when another cause of pain is suspected.
Routine radiography is not recommended unless other disease entities requiring these studies are in the differential diagnosis. Pelvic ultrasonography, CT scanning, and MRI are only useful in the case of advanced disease with endometrial cyst formation or severe anatomic distortion.
The most common sites of involvement found during laparoscopy are the following, in descending order:
Ovaries
Posterior cul-de-sac
Broad ligament
Uterosacral ligament
Rectosigmoid colon
Bladder
Distal ureter
Histologic demonstration of both endometrial glands and stroma in biopsy specimens obtained from outside the uterine cavity is required to make the diagnosis of endometriosis. Occasionally, the finding of fibrosis in combination with hemosiderin-laden macrophages is sufficient for a presumptive diagnosis.
For more on the workup of endometriosis, read here.
Medscape © 2017 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Michel E. Rivlin. Fast Five Quiz: Key Aspects of Endometriosis - Medscape - Oct 23, 2017.
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