Visual medicine

An Atlas of Endometriosis

by

Caroline Overton MD FRCOG

Consultant Obstetrician and Gynaecologist St Michael's University Hospital, Bristol, UK

1. A left ovarian endometrioma with adherent Fallopian tube. The uterus can be seen in the background.

2. Left ovarian cystectomy

3. A left ovarian cystectomy. The endometrioma is dissected from within the ovary. The cyst can be seen 'peeling' from within the ovary.

4. Nodules in the Pouch of Douglas (cul de sac) with scarring and puckering of the peritoneum

5. A close-up of nodules in the Pouch of Douglas (cul de sac) with scarring and puckering of the peritoneum

6. 'Gun powder' spots along the uterosacrals and peritoneum with peritoneal pockets

7. These endometrial pits within the endometrial cavity suggest adenomyosis

8. A powder burn nodule of endometriosis within the peritoneum. If histopathological examination is inconclusive, this appearance would suggest endometriosis

9. Evidence of perihepatic adhesions suggests pelvic infection rather than endometriosis

10. Severe endometriosis with obliteration of the Pouch of Douglas. There is a right ovarian endometrioma and a normal left ovary

11. Endometriosis with adhesion formation.

12. Close-up of endometriosis with adhesions.

13. Powder burn spot of the left uterosacral ligament.

14. Powder burn spot on the left ovary.

15. Close up of a powder burn spot on the left ovary

16(a). Utreteric obstruction right ureter

16(b). Utreteric obstruction right ureter

16(c). Utreteric obstruction right ureter

17. Deep nodule in the cul de sac with tethering of the rectum.

18. Deep nodule in the cul de sac.

19(a). Widespread superficial endometriosis in the cul de sac.

19(b). Widespread superficial endometriosis in the cul de sac.

20. Peritoneal pocketing in the cul de sac.

21. and after laparosopic excision.