Identifying Endometriosis
To identify endometriosis surgically, it is important to know the various ways that endometrial tissue presents on the internal organs.
Lesion Types: Adolescent vs Adults
Endometrial lesions present differently in adolescents than in adults. While lesion type, amount, and placement will vary from individual to individual, there are some trends to be aware of so that surgery is the most effective. Adolescents show clear, red, white, and brown lesions more than the blue-black (powder burn) lesions in adults. It is imperative to be aware of these differences because the lesions of adolescents are hard to spot and can go unnoticed in surgery. This will lead to prolonged treatment and additional surgeries. The lesion types can be viewed below. Read each type carefully to assess the qualities and best methods to spot them during surgery.
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Hemorrhagic Red Lesions
These are common in adolescents. Their high saturation and opaque nature can make these one of the easier lesions to notice. They usually appear as small clustered spots.
White Fibrotic Lesions
White fibrotic lesions are common but hard to identify due to the color and texture. The contrast between tissue color and these lesions usually indicates how well a surgeon can spot them. To help with this, it is best to look for areas of opaque and dense tissue.
Clear Vesicular Lesions
Clear lesions are common. They are small bumps filled with a liquid. They are glossy on the surface. When light reflects on them, they show up as clear bumps.
Brown Lesions
These are common. The brown lesions can have a tan, yellow, or red tint. They follow a more fibrous pattern. The texture can make it difficult to spot, but the coloring can help with identification. These can be confused with miliary or vesicular lesions. These are atypical in adolescents.
Blue-Black (Powder Burn) Lesions
Powder Burn lesions are less common in adolescents. They can still appear in this age group, so it is important to be aware of their appearance. Powder burn lesions are very dark and high contrast. They can have some texture.
Peritoneal Pocket
These are less common in endometriosis patients. The pocket is a large indentation or "hole" in the peritoneal lining. Due to their concave visuals, they are easier to spot and treat in surgery.
