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F. N. G. STARR, C.B.E., M.B.
Arch Surg. 1929;19(1):152-153. doi:10.1001/archsurg.1929.01150010155007.
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Since Sampson's1 exhaustive article on perforative hemorrhagic (chocolate) cysts of the ovary, one finds from time to time many and varied evidences of endometriosis. I have seen several such cases2 in which the appearance of the uterus closely resembles a leiomyoma, but in which there are many firm dense adhesions to the ovaries, pelvic wall, rectum and sigmoid. In these cases, when trying to arrive at a definite diagnosis, there has always been one definite symptom of which all the patients have complained, pain in the rectum preceding and often accompanying defecation.

The case I shall describe is, I think, unique in that there has never been any menstrual disturbance, and the patient has always been considered a strong, healthy member of her sex.

REPORT OF A CASE  Dr. Donald MacGillivray asked me to see a maiden lady, aged 38, on the evening of March 16, 1927. The


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