Endometriosis after "pelvic cleanout"

In many patients endometriosis is ultimately treated by total abdominal hysterectomy and bilateral salpingo-oophorectomy. Endometriosis in a 31-year-old, white, multiparous woman demonstrates the unusual nature of this disease. Five years after a total abdominal hysterectomy and four years after a bilateral salpingo-oophorectomy for a pelvic abscess, she had an endometrioma above the apex of the vagina. Her previous surgery had revealed no evidence of endometriosis. This patient's age, parity, and previous pelvic cleanout made her an unusual candidate for this disease.