子宫内膜异位症（PPT讲稿）Endometriosis

Endometriosis

Endometriosis

Definition Endometriosis is usually defined as the pg resence of endometrial like tissue that is lands and stroma outside the endometrium in uterine cavity and myometrium

Definition Endometriosis is usually defined as the presence of endometrial-like tissue, that is, glands and stroma, outside the endometrium in uterine cavity and myometrium

Common sites of endometriosis The most comimon sites .uterosacral ligarrerit rectouterine pouch ovary others: Fallopian tube o uterine serosa Endometrial plants Ns fallopian tube sigmoid colon(乙状结肠) bEndometnal outside of the pelvis Rectum Bladder Umbilicus(r) bladder, kidney

Common sites of endometriosis The most common sites： • uterosacral ligament • rectouterine pouch • ovary Others： • uterine serosa • fallopian tube • sigmoid colon (乙状结肠) outside of the pelvis : • Umbilicus(脐) , bladder, kidney

Prevalence present in 10/% of women in reproductive age group especially from age 25 to 45 normally not seen before age 15 or after menopause less and late childbearing latest study, more frequent menses(cycle length s 27 days)and prolonged menstrual flow(e 1 week)2 times risk

Prevalence • present in 10%-15% of women in reproductive age group, especially from age 25 to 45 • normally not seen before age 15 or after menopause • less and late childbearing • latest study: more frequent menses (cycle length ≤ 27 days ) and prolonged menstrual flow (≥ 1 week) 2 times risk

Pathogenesis Theories of sources of ectopic endometrium Implantation theory(种植学说)— -samps0n1921 endometriurn transfer→ implant→grow etrograde menstruation(经血逆流) theory 2 iatrogenic(医源性的) implantation 3. transport by lymph and vein

Pathogenesis Theories of sources of ectopic endometrium • Implantation theory (种植学说) ——Sampson 1921 endometrium transfer → implant →grow ⒈retrograde menstruation (经血逆流) theory ⒉iatrogenic (医源性的) implantation ⒊ transport by lymph and vein

Pathogenesis Theories of source of ectopic endometrium metaplasia theory of coelomic epithelium(体腔上皮 化生学说) induction theory(诱导学说)

Pathogenesis Theories of source of ectopic endometrium • metaplasia theory of coelomic epithelium(体腔上皮 化生学说) • induction theory（诱导学说）

Pathogenesis 用C0 related的en0met10s5 Genetic Factors: high risk in first-degree relatives Immunologic Factors o Inflammation Character of uterine eutopic endometrium

Pathogenesis Factors related with endometriosis • Genetic Factors ：high risk in first-degree relatives • Immunologic Factors • Inflammation • Character of uterine eutopic endometrium

Pathology ectopIc endorretrlum hemorrhage proliferation of fibrous tissue adhesions dark blue or dark brown spots scarring nodules or cysts

Pathology ectopic endometrium ↓ hemorrhage ↓ proliferation of fibrous tissue ＆ adhesions ↓ dark blue or dark brown spots ↓ scarring nodules or cysts

Pathology Ovarian endometriosis Peritoneal endometriosis Deep infiltrating endometriosis others

Pathology • Ovarian endometriosis • Peritoneal endometriosis • Deep infiltrating endometriosis • others

Gross appearance ovarian engoneirjosis red blue or brown spots endometriomas chocolate cysts aspIng forceps ovary

Gross appearance : ovarian endometriosis • red, blue, or brown spots • endometriomas —— chocolate cysts