By Caroline Overton
This fantastically and comprehensively illustrated Atlas offers an invaluable academic instrument for trainees and normal ObGyns who will not be up to date with fresh study within the . The ebook is a completely revised 3rd version summarizing advances within the prognosis and administration of the sickness. quite accelerated for this variation are sections on ultrasound and MRI imaging, and non-surgical interventions. New for this variation are aseries of case-histories that extend on subject matters into consideration and elevate the pedagogic worth. For the 1st time, illustrations should be absolutely built-in with the textual content. as with any Atlases, the visible method isvalued via many purchasers as a brief and noteworthy approach to assimilating crucial details on a subject or ailment.
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Extra resources for Atlas of Endometriosis,
CLINICAL FINDINGS Bowel and extrapelvic endometriosis Pelvic endometriosis Clinical findings in endometriosis are markedly variable. In mild cases, routine gynaecological examination is likely to reveal no abnormality. A common feature of bimanual pelvic examination is that of discomfort, especially if performed during the premenstrual phase. 1). These features are demonstrated perhaps most clearly by a combined vaginal and rectal examination. If the pouch of Douglas is involved extensively, the uterus will become fixed in retroversion, and the adnexa will appear immobile.
White vesicular implants may also be seen when there is an absence of bleeding, and the vast majority have histologically proven endometriotic tissue. These implants may represent very early stages in the development of an implant before vascularisation has been established and haemorrhage ensues. 7). The colour of these implants is usually whitish or sometimes yellow. Histologically, cystic glandular structures with stroma are found enclosed in the subperitoneal tissue. The peritoneum overlying the implant is often vascularised, and an accumulation of secretory products results in a cystic structure containing whitish or yellow opaque fluid.
12 Transrectal scanning provides more effective imaging of the deep pelvis. 14 Three-dimensional ultrasound demonstrating a volume block of the ovary. An endometriotic cyst is clearly outlined within the ovarian substance. 15 Three-dimensional ultrasound showing multisectional reconstruction of a large endometriotic cyst – alterations in the image planes confirm a lack of preserved, normal ovarian tissue Owing to the poor specificity and high radiation dose, CT has been replaced by magnetic resonance imaging (MRI) in the evaluation of pelvic endometriosis.