Case of a Girl with Painful Periods, Pain with Bowel Movements, and Dyspareunia

Chapter

Abstract

A 16-year-old girl presents to office with complaint of persistent abdominal and pelvic pain. She reports cramping and sharp pain that initially started prior to her menstrual cycle and lasted through the first 2–3 days of her menses, but now pain occurs daily. Her pain is most severe before and during her menses, which are regular. She has intermittent constipation and pain with bowel movements but no dysuria or increased frequency of urination. She is currently sexually active. She has missed multiple days of school due to her pain. Family history is significant for endometriosis and diabetes. Ibuprofen and an oral contraceptive pill provide no relief. Physical exam, as well as pelvic ultrasound, is normal. She undergoes a diagnostic laparoscopy, which reveals clear vesicular and red-flame-like lesions scattered along with posterior cul-de-sac and the bilateral uterosacral ligaments. Final pathology reveals endometrial stroma and glands confirming diagnosis of endometriosis.

Keywords

Adolescent Endometriosis Dysmenorrhea Hormonal suppression Chronic pelvic pain Laparoscopy 

References

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Suggested Educational Reading

  1. ACOG Committee Opinion: No 310. Endometriosis in adolescents. Obstet Gynecol 2005;105:921.Google Scholar
  2. ACOG Committee Opinion: No 114. Management of Endometriosis July 2010. Reaffirmed 2016.Google Scholar
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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Norton Children’s Gynecology SpecialistsLouisvilleUSA
  2. 2.University of Louisville School of Medicine, Kosair Children’s HospitalLouisvilleUSA

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