[Extrapelvic endometriosis is a difficult diagnosis].

Extrapelvic endometriosis is a rare type of endometriosis. The diagnosis can be challenging, especially if the patient lacks characteristic endometriosis symptoms. This case report presents a 27-year-old woman diagnosed with both primary umbilical endometriosis and infiltrating endometriosis of the diaphragm. The woman presented with a painful bluish tumour in the umbilicus and cyclic pain in her upper right abdomen, but no lower abdominal pain. Endometriosis should be one of the differential diagnoses when symptoms like pain and/or swelling is cyclic and menstrual-related.

[Ultrasound scan did not locate misplaced intrauterine devices].

One of the rare but serious complications of intrauterine contraception is perforation of the uterine wall at insertion. We present two cases where intrauterine devices went missing. In both cases abdominal and vaginal ultrasound scan was performed to locate the intrauterine device. They were not found and doctors concluded that the intrauterine devices were lost by expulsion. One intrauterine device came out of the rectum by itself; the other was found and removed from inside the abdomen at laparoscopy. An X-ray examination should have been done before the conclusion of expulsion.

Transvaginal ultrasonography of rectosigmoid endometriosis: interobserver variation of lesion size.

This study evaluates the interobserver variation of transvaginal ultrasonographic measurements of the size of deep infiltrating endometriosis lesions in the rectosigmoid wall performed by an experienced and a less experienced sonographer. Fifteen outpatient women were seen for a gynecologic examination and 24 women were seen with rectosigmoid endometriosis. Transvaginal ultrasonography was performed independently by two observers with a focus on the presence and size of rectosigmoid endometriosis. The senior observer had several years of experience, whereas the junior observer was a medical student with no prior experience in transvaginal ultrasonography. The findings of the two observers were identical concerning the identification of rectosigmoid endometriosis. The probability of differences in size within 30% of the mean was 0.81, 0.63 and 0.61 for length, width and depth, respectively. Our data suggest that fair skills in this technique can be acquired by inexperienced examiners within a short period of time.