ABSTRACT
Endometriosis can be recognised by the presence of the classical ‘powder burn’ lesions (the numerous, randomly scattered, diffuse, dark lesions being reminiscent of the effect of gunpowder at short range) or the less common florid red ‘flare’ lesions. Other evidence of endometriosis in the pelvis is the presence of fibrin deposition either as adhesions or a diffuse layer on the peritoneal surface, localised scar tissue associated with old, burnt out endometriotic sites or defects in the peritoneal surface. The classical lesions are easy to recognise but the other appearances may be overlooked or misdiagnosed especially by less experienced gynaecological surgeons and are particularly difficult to see if situated in the ovarian fossa the proper inspection of which may be frustrated by the ovary itself.
