Presentation
Recurrent pelvic pain and primary infertility.
Patient Data
Enlarged ovaries are present in the Douglas pouch, close to one another (known as the "kissing ovaries sign"). Multiple hypointense T2 lesions are evident, indicating endometriotic lesions. The left ovary displays a small cyst of high T1 and T2 signal, indicating an endometrioma. Additionally, both ovaries are attached to the rectum via an adhesive band.
The fallopian tubes are dilated and tortuous (hydrosalpinx).
A collection of fluid in the pelvic region has been observed above the urinary bladder with a measurement of approximately 10cm x 4cm.
Kissing ovaries sign
Case Discussion
This case illustrates findings of advanced endometriosis with adhesions in the pelvis, resulting in bilateral hydrosalpinx, kissing ovaries sign, and a non-dependent fluid collection.
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