2020 Online Salon
Endometriosis: Potential Origins and Pathophysiology
- Entrant Name: Natalie Koscal
- Membership Type: Professional Submission
- Address: Cambridge, Massachusetts USA
- Client: The New England Journal of Medicine
- Copyright: 2020 The Massachusetts Medical Society
- Medium/software used: Adobe Photoshop and Adobe Illustrator
- Final presentation format: Printed and online journal
- Primary Audience: Health care professionals, especially those in the fields of obstetrics and gynecology.
Pelvic endometriosis is a complex disorder that is difficult to diagnose and treat due to its unknown natural history, its multisystemic nature, and symptom heterogeneity. This illustration utilizes anatomical rendering and organizational schematic elements to meet the challenge of succinctly summarizing this complexity. A superoposterior view was chosen because it is a recognizable laparoscopic perspective and allows for easy visualization of disease manifestations. The uterine wall was cut to demonstrate the abnormal route that shed endometriotic lining takes in retrograde menstruation, a postulated disease origin. A cross-sectional inset elucidates the degree of tissue penetration of a deep endometriotic lesion. Within the schematic insets, arrows indicate interactions between endocrine, immunologic, proinflammatory, and proangiogenic processes (dotted arrow shows a postulated interaction).