| Abstract [eng] |
Fallopian tube endometriosis is a rare yet clinically significant form of endometriosis characterized by the growth of endometrial-like cells within the fallopian tubes. Endometriosis the clinical presentation varies widely - from asymptomatic cases to severe chronic pelvic pain, dysmenorrhea, dyspareunia, and even infertility. Although endometriosis most commonly affects women of reproductive age, studies indicate it may also occur in adolescents and postmenopausal women. Fallopian tube endometriosis is of particular concern due to its direct impact on fertility. It may cause tubal obstruction, adhesions, peristaltic dysfunction, and other functional or structural alterations that impair fertilization. In recent decades, the incidence of infertility has risen globally, including in Lithuania, with endometriosis identified as one of the leading causes. Literature indicates that 30 – 40 percent of female infertility cases are linked to tubal obstruction, a significant portion of which may be attributed to endometriotic lesions. Proximal tubal occlusion accounts for 10 – 25 percent of these cases and is frequently associated with endometriosis. Despite its clinical importance, fallopian tube endometriosis often goes undiagnosed due to nonspecific symptoms and the lack of effective non-invasive diagnostic tools. It is most commonly detected during infertility workups or incidentally during diagnostic laparoscopy. Early diagnosis of fallopian tube endometriosis is crucial, as timely treatment can significantly improve fertility outcomes and reduce long-term complications. Diagnostic approaches include ultrasonography, magnetic resonance imaging (MRI), and laparoscopy. Treatment strategies depend on symptom severity, patient age, and reproductive plans, and include hormonal therapies and surgical interventions. A multidisciplinary and individualized approach can effectively reduce symptoms and improve both quality of life and fertility outcomes. The thesis presents a clinical case of a 48-year-old female patient who sought medical attention due to acyclic bleeding and a dull pain in the lower abdomen. The clinical presentation was consistent with fallopian tube endometriosis, however, imaging studies raised suspicion of a neoplastic process. The final diagnosis, fallopian tube endometriosis, was confirmed only after histological examination, highlighting the diagnostic complexity of this condition and the necessity of invasive methods to establish a definitive diagnosis. Keywords: endometriosis, fallopian tube endometriosis, tubal endometriosis, infertility, tubal obstruction. |
