Endometriosis and Pelvic Tumours

Abstract

The laparoscopic appearances of endometriosis show wide variation, from minimal disease with ‘powder burns’ to large chocolate cysts with adhesions. The clinical features may be similar to pelvic inflammatory disease, with which it can be confused. Ovarian endometriosis must also be distinguished from functional ovarian cysts and tumours, especially dermoids and pseudomucinous cysts. Small endometriotic cysts can be missed on laparoscopic examination unless a double puncture technique is used, lifting the ovary and examining both lateral and medial surfaces. A small lesion will appear well defined and black (Fig.6.1). A slightly larger endometrioma often causes puckering of the ovarian cortex (Fig.6.2). Fig.6.3 shows an endometrioma at the lower pole of the ovary with a thin-walled fimbrial cyst attached to the tube.