Russell H. Morgan Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA.
Emerg Radiol. 2023 Jun;30(3):377-385. doi: 10.1007/s10140-023-02128-7. Epub 2023 Apr 1.
The purpose of this pictorial essay is to highlight atypical and unusual presentations of endometriosis that can be missed or misinterpreted in the emergency setting. Although endometriosis is a chronic disease, it can present acutely with symptoms and imaging mimicking more common acute gynecologic, gastrointestinal, or urinary conditions as well as neoplasms. Furthermore, patients may present emergently prior to an established diagnosis of endometriosis. Here, we present a range of cases including endometrioma rupture and infection, urinary tract involvement and obstruction, bowel obstruction, appendicitis, gastrointestinal infiltration, abdominal masses, and thoracic involvement. Pelvic ultrasound and MRI are the most valuable imaging modalities in the assessment of endometriosis. CT findings are non-specific, but given the widespread use of CT in emergency settings, it is important to recognize CT findings suggestive of the diagnosis in the right clinical setting.
本影像学专题的目的是强调子宫内膜异位症的一些非典型和不常见表现，这些表现可能会在急症环境中被忽视或误诊。尽管子宫内膜异位症是一种慢性疾病，但它也可能会突然出现，其症状和影像学表现类似于更常见的急性妇科、胃肠道或泌尿系统疾病以及肿瘤。此外，患者可能在确诊子宫内膜异位症之前就出现紧急情况。在这里，我们展示了一系列病例，包括子宫内膜囊肿破裂和感染、泌尿道受累和梗阻、肠梗阻、阑尾炎、胃肠道浸润、腹部肿块和胸部受累。盆腔超声和 MRI 是评估子宫内膜异位症最有价值的影像学检查方法。CT 检查结果不具有特异性，但鉴于 CT 在急症环境中的广泛应用，在正确的临床环境中识别提示该诊断的 CT 表现非常重要。
