Presentation
Past severe endometriosis with low bowel resection. Managed well since on oral contraceptive pills.
Patient Data
ANTERIOR COMPARTMENT: normal.
MIDDLE COMPARTMENT:
Uterus: Anteverted anteflexed 90 mm long. Arcuate morphology. Endometrium 3 mm thin and regular. Junctional zone indistinct but not thickened (6 mm anterior 7 mm posterior). No myometrial lesion. Reduced mobility.
Vagina: In the posterior vault is an ill-defined 18 mm T2 dark thickening with T1 hyperintense foci, suggesting blood products within vault endometriosis.
Ovaries: normal.
Fallopian tubes: normal.
POSTERIOR COMPARTMENT: postoperative presacral T2 dark regular thickening and bowel anastomosis.
Case Discussion
The left/posterior vagina vault show some T1 hyperintense foci which may represent blood products in vault deep endometriosis, this could be confirmed by sonovaginography if clinically required.