Female Suffering From Pelvic Pain Since 18 Months

A 29-year-old female presented in the department with the chief complaints of lower abdominal pain for 4 years occurring with her periods. For the last 18 months pain has occurred in between periods. The pain is dull and constant across the lower abdomen. Her periods are regular and she have no history of menorrhagia, intermenstrual or postcoital bleeding. The patient is married and has deep dyspareunia which makes her interrupt intercourse. Physical examination Generalized lower-abdominal tenderness, particularly in the suprapubic area but no masses are palpable.

Speculum examination is unremarkable. On bimanual palpation the uterus is axial and fixed with cervical excitation. The pouch of Douglas is very tender and contains a mass. The adnexae are both tender but no adnexal masses are palpable. What is the most likely diagnosis? *This case is from Docplexus editorial team for…