Allen Masters Peritoneal Defect: A Potential Pathway to Deep Infiltrating Rectovaginal Endometriosis?

摘要

Deep infiltrative endometriosis of the recto vaginal septum can be one of the most severe forms of endometriosis. It is characterized by spherically shaped lesions situated deep in the rectovaginal septum and often only visible as a small typical lesion at laparoscopy or not visible at all. This lesion is often more palpable than visible and can be tender during pelvic examination, especially if the patient is examined at the time of menstruation, and can cause severe dyspareunia, back pain, and sometimes bowel symptoms. Many theories have been suggested for this type of endometriosis including true deep infiltrating endometriosis caused by the invasion of a very active peritoneal lesion deep in the retroperitoneal space and pseudo-deep infiltrating endometriosis or "adenomyosis" of the rectovaginal septum and congenital endometriosis of the rectovaginal septum [1-4].