Nongynecological endometriosis presenting as an acute abdomen

article OA: closed CC0 ⤵ 14 in-corpus citations
AI-generated summary by claude@2026-06+body, 2026-06-07

This pictorial essay analyzes nongynecological endometriosis that may present as an acute abdominal emergency, discussing atypical presentations, unusual sites, complications, and diagnostic considerations with imaging features.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text

This pictorial essay investigates nongynecological manifestations of endometriosis that can present to emergency departments with signs of an acute abdomen, analyzing atypical clinical presentations, unusual sites, radiologic findings across CT, MRI, and ultrasound, and differential diagnostic considerations. It describes that in patients without a known history of endometriosis, diagnosis may be delayed until surgical or histopathological evaluation, and that some presentations reflect complications such as bowel obstruction or appendicitis requiring urgent intervention. The paper’s main limitation is that it is not an original clinical study but a synthesis of imaging-based examples, so diagnostic performance or accuracy is not quantified. This paper is centrally about endometriosis — specifically nongynecological endometriosis presenting as acute abdominal emergencies and its radiologic appearances.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Full text 7,442 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Abstract

Endometriosis is a highly prevalent disease that affects up to 10 % of menstruating women. Patients commonly present with pelvic pain or infertility, although the range of clinical symptoms varies widely. Affected women may be asymptomatic or experience mild, moderate, or severe pain that fluctuates with hormonal cycles. Patients who suffer extreme pain may seek immediate care and present to the emergency department with clinical signs of an acute abdomen. In the case of patients without a prior history of endometriosis, the differential diagnosis is broad and making the correct clinical and radiologic diagnosis in the emergency setting can be challenging. In some cases, the diagnosis is only made after surgical or histopathological analysis. Prompt and accurate clinical and radiological evaluation is necessary because complications of endometriosis, such as bowel obstruction and appendicitis, may require immediate surgical intervention. This pictorial essay analyzes nongynecological manifestations of endometriosis that may have a clinical presentation of an acute abdominal emergency. Atypical clinical presentations and unusual sites and complications of endometriosis are discussed, as well as the differential diagnostic considerations. The radiologic features of endometriosis are shown on multiple modalities, including computed tomography, magnetic resonance imaging, and ultrasound. Similar content being viewed by others

References

Eskenazi B, Warner ML (1997) Epidemiology of endometriosis. Obstet Gynecol Clin North Am 24(2):235–258 Giudice LC (2010) Clinical practice. Endometriosis. N Engl J Med 362(25):2389–2398 Practice Committee of the American Society for Reproductive Medicine (2008) Treatment of pelvic pain associated with endometriosis. Fertil Steril 90(5 Suppl):S260–S269 Golditch IM (1965) Endometriosis presenting as an acute abdominal emergency. Obstet Gynecol 26(6):780–785 Anonymous (1997) Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril 67(5):817–821 Woodward PJ, Sohaey R, Mezzetti TP Jr (2001) Endometriosis: radiologic–pathologic correlation. Radiographics 21(1):193–216 Kupfer MC, Schwimer SR, Lebovic J (1992) Transvaginal sonographic appearance of endometriomata: spectrum of findings. J Ultrasound Med 11(4):129–133 Atri M, Nazarnia S, Bret PM, Aldis AE, Kintzen G, Reinhold C (1994) Endovaginal sonographic appearance of benign ovarian masses. Radiographics 14(4):747–760, discussion 761–742 Siegelman ES, Outwater EK (1999) Tissue characterization in the female pelvis by means of MR imaging. Radiology 212(1):5–18 Togashi K, Nishimura K, Kimura I, Tsuda Y, Yamashita K, Shibata T, Nakano Y, Konishi J, Konishi I, Mori T (1991) Endometrial cysts: diagnosis with MR imaging. Radiology 180(1):73–78 Gougoutas CA, Siegelman ES, Hunt J, Outwater EK (2000) Pelvic endometriosis: various manifestations and MR imaging findings. AJR 175(2):353–358 Bennett GL, Harvey WB, Slywotzky CM, Birnbaum BA (2003) CT of the acute abdomen: gynecologic etiologies. Abdom Imaging 28(3):416–432 Beavis AL, Matsuo K, Grubbs BH, Srivastava SA, Truong CM, Moffitt MN, Maliglig AM, Lin YG (2011) Endometriosis in para-aortic lymph nodes during pregnancy: case report and review of literature. Fertil Steril 95(7):2429.e9–2429.e13 Fishman EK, Scatarige JC, Saksouk FA, Rosenshein NB, Siegelman SS (1983) Computed tomography of endometriosis. J Comput Assist Tomogr 7(2):257–264 Jenkins S, Olive DL, Haney AF (1986) Endometriosis: pathogenetic implications of the anatomic distribution. Obstet Gynecol 67(3):335–338 Jubanyik KJ, Comite F (1997) Extrapelvic endometriosis. Obstet Gynecol Clin North Am 24(2):411–440 De Ceglie A, Bilardi C, Blanchi S, Picasso M, Di Muzio M, Trimarchi A, Conio M (2008) Acute small bowel obstruction caused by endometriosis: a case report and review of the literature. World J Gastroenterol 14(21):3430–3434 Yantiss RK, Clement PB, Young RH (2001) Endometriosis of the intestinal tract: a study of 44 cases of a disease that may cause diverse challenges in clinical and pathologic evaluation. Am J Surg Pathol 25(4):445–454 Abrao MS, Goncalves MO, Dias JA Jr, Podgaec S, Chamie LP, Blasbalg R (2007) Comparison between clinical examination, transvaginal sonography and magnetic resonance imaging for the diagnosis of deep endometriosis. Hum Reprod 22(12):3092–3097 Collins DC (1955) A study of 50,000 specimens of the human vermiform appendix. Surg Gynecol Obstet 101(4):437–445 Mittal VK, Choudhury SP, Cortez JA (1981) Endometriosis of the appendix presenting as acute appendicitis. Am J Surg 142(4):519–521 Gustofson RL, Kim N, Liu S, Stratton P (2006) Endometriosis and the appendix: a case series and comprehensive review of the literature. Fertil Steril 86(2):298–303 Levine CD, Aizenstein O, Wachsberg RH (2004) Pitfalls in the CT diagnosis of appendicitis. Br J Radiol 77(921):792–799 Choudhary S, Fasih N, Papadatos D, Surabhi VR (2009) Unusual imaging appearances of endometriosis. AJR 192(6):1632–1644 Shook TE, Nyberg LM (1988) Endometriosis of the urinary tract. Urology 31(1):1–6 Price DT, Maloney KE, Ibrahim GK, Cundiff GW, Leder RA, Anderson EE (1996) Vesical endometriosis: report of two cases and review of the literature. Urology 48(4):639–643 Savelli L, Manuzzi L, Pollastri P, Mabrouk M, Seracchioli R, Venturoli S (2009) Diagnostic accuracy and potential limitations of transvaginal sonography for bladder endometriosis. Ultrasound Obstet Gynecol 34(5):595–600 Umaria N, Olliff JF (2000) MRI appearances of bladder endometriosis. Br J Radiol 73(871):733–736 Del Frate C, Girometti R, Pittino M, Del Frate G, Bazzocchi M, Zuiani C (2006) Deep retroperitoneal pelvic endometriosis: MR imaging appearance with laparoscopic correlation. Radiographics 26(6):1705–1718 Bennett GL, Slywotzky CM, Cantera M, Hecht EM (2010) Unusual manifestations and complications of endometriosis—spectrum of imaging findings: pictorial review. AJR 194(6 Suppl):WS34–WS46 Al-Khawaja M, Tan PH, MacLennan GT, Lopez-Beltran A, Montironi R, Cheng L (2008) Ureteral endometriosis: clinicopathological and immunohistochemical study of 7 cases. Hum Pathol 39(6):954–959 Stillwell TJ, Kramer SA, Lee RA (1986) Endometriosis of ureter. Urology 28(2):81–85 Haim N, Shapiro-Feinberg M, Zissin R (2005) Incisional endometriomas: CT findings. Emerg Radiol 11(3):162–163 Hensen JH, Van Breda Vriesman AC, Puylaert JB (2006) Abdominal wall endometriosis: clinical presentation and imaging features with emphasis on sonography. AJR 186(3):616–620 Khoo JJ (2003) Scar endometriosis presenting as an acute abdomen: a case report. Aust N Z J Obstet Gynaecol 43(2):164–165 Balleyguier C, Chapron C, Chopin N, Helenon O, Menu Y (2003) Abdominal wall and surgical scar endometriosis: results of magnetic resonance imaging. Gynecol Obstet Invest 55(4):220–224 Acknowledgments The authors would like to thank Peerapod Chiowanich, MD, for contributing Fig. 9 and Stephen M. Parker, ELS, for assisting with the editing of the manuscript. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Hwang, B.J., Jafferjee, N., Paniz-Mondolfi, A. et al. Nongynecological endometriosis presenting as an acute abdomen. Emerg Radiol 19, 463–471 (2012). https://doi.org/10.1007/s10140-012-1048-x Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s10140-012-1048-x

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

mesh:D004715endometriosis

MeSH descriptors

Abdomen, Acute Endometriosis Abdomen, Acute Abdomen, Acute Adult Appendicitis Appendicitis Appendicitis Cicatrix Cicatrix Cicatrix Diagnosis, Differential Diagnostic Imaging Diagnostic Imaging Endometriosis Endometriosis Female Gastrointestinal Diseases Gastrointestinal Diseases Gastrointestinal Diseases

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (36)

Cited by (14)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-05-13T22:16:17.081435+00:00
unpaywall
last seen: 2026-06-02T02:00:03.124865+00:00
License: CC0 · commercial use OK