Pitfalls in clinical, laparoscopic and histologic diagnosis of endometriosis

Endometriosis frequently presents diagnostic problems. Its symptoms and findings are non-specific and there are no non-invasive diagnostic tests. Laparoscopy is the most valuable diagnostic tool for use in a patient with endometriosis. Laparoscopic evaluation of the pelvis should be thorough, with attention paid to commonly affected but poorly accessible areas. Associated signs such as peritoneal congestion, adhesions and peritoneal defects may be suggestive of endometriosis. In questionable cases, laparoscopic biopsies of suspicious lesions should be performed. Histologic diagnosis of endometriosis is confirmatory of the disease but may sometimes be difficult. Endometriosis continues to present many problems in the area of diagnosis and management, and fully deserves to be studied further.