Diagnostic Errors of Nodular Adenomyosis on the Example of a Clinical Case

Abstract

Introduction. One of the less common forms of adenomyosis is the nodular type, characterized by localized foci composed of damaged endometrial glands and altered muscle and connective tissue fibers. Diagnosing nodular adenomyosis is oſten challenging, with the diagnosis frequently made intraoperatively or during histological examination.

The purpose of the work. To analyze a clinical case involving a patient with nodular adenomyosis and a prolonged history of pelvic pain syndrome, aiming to identify diagnostic errors associated with this condition.

Materials and methods. A clinical case was reviewed based on the patient’s medical history and treatments conducted prior to admission to the Gynecology Department of the Stavropol State Medical University Medical Center.

Results and discussion. The chronology of diagnosis and treatment, along with an analysis of errors that led to the chronicity of the pathological process and subsequent deterioration in the patient’s quality of life and overall condition, is presented. This clinical case demonstrated that a gynecologist’s primary responsibility when examining patients with pelvic pain syndrome is to conduct detailed diagnostics. The authors re-evaluated the patient’s magnetic resonance imaging scans and suspected the diagnosis of “nodular adenomyosis”, which justified performing laparoscopy to confirm the condition. During the procedure, the diagnosis was confirmed, and the nodular adenomyosis was excised simultaneously. To prevent adhesion formation, an anti-adhesion barrier was applied.

Conclusion. Laparoscopy is one of the most critical methods for diagnosing pelvic pain syndrome, as it enables early diagnosis, detailed examination of pelvic and abdominal organs, and the simultaneous execution of therapeutic interventions.