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    Subjects/OBG/Endometriosis and Adenomyosis
    Endometriosis and Adenomyosis
    medium
    baby OBG

    A 28-year-old nulliparous woman with a 5-year history of progressive dysmenorrhea and infertility undergoes diagnostic laparoscopy. Findings include powder-burn lesions on the peritoneum, chocolate cysts on both ovaries, and dense adhesions between bowel and pelvic sidewall. The uterus appears normal on inspection. Which feature most reliably distinguishes this presentation from adenomyosis?

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