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Dan C. Martin, MD
UT Medical Group, Inc.

University of Tennessee Health Science Center (UTHSC)

UTHSC Academic Office

Daniel Clyde Martin, M.D.
UT Medical Group, Inc.
Infertility and Gynecology
Reproductive Surgery
Germantown Office Building
7945 Wolf River Boulevard
Suite 320
Germantown, Tennessee
TN 38138-1733

(901) 347-8331
(901) 347-8188 fax
Directions to Office

Updated information is at
UTMG 2006

Click for information on:
Glenn Ann Martin, Ph.D.
Clinical Psychologist

Adhesions and Foreign Bodies

Adapted from "Recognition of Endometriosis" in
Laparoscopic Appearance of Endometriosis, Lecture Supplement
Martin DC (ed), Resurge Press, Memphis, (c)1991

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Endometriosis can be hidden within adhesions (Sampson, 1921) or behind pelvic foreign bodies. (Martin, 1991) Endometriosis was found in 39% to 50% of adhesions. This was frequently at the base of adhesions when the peritoneum was resected. (Jansen & Russell, 1986; Martin, Hubert, Vander Zwaag, & El-Zeky, 1989) Furthermore, endometriosis was hidden behind carbon in 16% of patients (Martin, et al., 1989) and behind suture in some patients. (Martin, Ahmic, El-Zeky, Vander Zwaag, Pickens, & Cherry, 1990)

Adhesions must be lysed for complete examination. Cancer has been found behind adhesions and associated with endometriosis. (Hunt, 1997)

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Bibliography

bulletHunt, R. B. (1997). Laparoscopic management of adnexal masses, presented at Gynecologic Surgery for Clinicians, Chicago, Illinois, May 14, 1997 No. 
bulletJansen, R. P. S., & Russell, P. (1986). Nonpigmented endometriosis: clinical, laparoscopic, and pathologic definition. Am J Obstet Gynecol, 155, 1154-1159.
bulletMartin, D. C. (1991). Laparoscopic Appearance of Endometriosis. First Revision. Color Atlas (Second ed.). Memphis: Resurge Press. 
bulletMartin, D. C., Ahmic, R., El-Zeky, F. A., Vander Zwaag, R., Pickens, M. T., & Cherry, K. (1990). Increased histologic confirmation of endometriosis. J Gynecol Surg, 6, 275-279.
bulletMartin, D. C., Hubert, G. D., Vander Zwaag, R., & El-Zeky, F. A. (1989). Laparoscopic appearances of peritoneal endometriosis. Fertil Steril, 51, 63-67.
bulletSampson, J. A. (1921). Perforating hemorrhagic (chocolate) cysts of the ovary. Their importance and especially their relation to pelvic adenomas of the endometrial type ("adenomyoma" of the uterus, rectovaginal septum, sigmoid, etc.). Arch Surg, 3, 245-323.

Adapted from "Recognition of Endometriosis" in
Laparoscopic Appearance of Endometriosis, Lecture Supplement
Martin DC (ed), Resurge Press, Memphis, (c)1991

The color illustrations that accompanied this paper are in the Color Atlas.

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