Presentation
Endometriosis, laparoscopic surgery. Left abdominal pain and bloating.
Patient Data
ANTERIOR COMPARTMENT: normal.
MIDDLE COMPARTMENT:
Uterus: normal. Anteverted 83 mm long with normal morphology. Endometrium 2 mm thin and regular. Junctional zone is indistinct but not thickened. No myometrial lesion. Normal mobility.
Ovaries: Left ovary multifollicular, AFC >20, peripheral follicles. Left adnexa 14 mm simple paraovarian cyst.
Fallopian tubes: normal.
POSTERIOR COMPARTMENT:
Rectosigmoid colon: Normal anal canal and rectum. At the left pelvic sidewall there is a subtle asymmetric thickening of the sigmoid, 4 mm in depth that corresponds to the TVUS.
Pouch of Douglas: normal. Torus uterinus: normal.
Uterosacral ligaments: normal. Rectovaginal septum: normal.
UPPER ABDOMEN: No diaphragmatic endometriosis seen.
INCIDENTAL FINDINGS: Left kidney upper pole 8 mm simple cortical cyst.
Case Discussion
Solitary sigmoid subtle asymmetric thickening corresponds to the non-tender superficial bowel endometriosis at TVUS. No other bowel endometriosis identified. This MRI is very easily reported as a false negative if prior DIE TVUS is not checked - the bowel lesion persists adjacent to the left ovary.
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