Sampson’s Theory of Implantation Endometriosis

Batt, Ronald E.

doi:10.1007/978-0-85729-585-9_8

Ronald E. Batt M.D., Ph.D.²

1084 Accesses

Abstract

From a cursory examination of the literature, one might conclude that research and authorship on adenomyomas passed seamlessly and directly from Cullen to Sampson in 1921; Cullen’s last contribution appearing in Volume two and Sampson’s first article in Volume three of the Archives of Surgery.¹ Such was not the case. Unlike the clear and seamless continuity from von Recklinghausen to Cullen, the transfer of authority from Cullen to Sampson was mediated and complicated. Cullen remained the undisputed authority on uterine adenomyomas, but not of extrauterine adenomyomas. In the sense that Sampson postulated a novel theory of pathogenesis to explain the many extrauterine adenomyomas described by Cullen – and in that sense only – there was continuity: mutual interest in the same subject, but the torch had not been passed as it had from von Recklinghausen to Cullen. In every other sense, the transition was marked by discontinuity.

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Notes

1.
Cullen TS. Three cases of subperitoneal pedunculated adenomyoma. Archives Surgery 1921;2:443–454. Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323:245.
2.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323.
3.
Casler DB. A unique, diffuse uterine tumor, really an adenomyoma, with stroma, but no glands. Menstruation after complete hysterectomy due to uterine mucosa in remaining ovary. Transactions of the American Gynecological Society. 1919;44:69–84. It is unknown when Sampson first heard of Casler’s case. He could have learned from Cullen’s presentation at the annual meeting of the New York State Medical Society at Syracuse, New York on May 7, 1919, or have read Cullen’s article in the August 1919 issue of the American Journal of Obstetrics and Diseases of Women and Children. On the other hand Sampson may have heard Casler present at the American Gynecological Society or read Casler’s article in the Transactions of the American Gynecological Society, 1919;44:69–84. What is known beyond doubt, Casler’s case of the externally menstruating ovary directly inspired Sampson’s hypothesis of the internally menstruating ovary. Casler precipitated an experiment of nature when he placed a cigarette drain in the vaginal cuff after hysterectomy. The drain created a fistula, an artificial channel connecting the left ovary and the vagina. When, 4 years later, an ovarian endometrioma ruptured – it ruptured into the fistulous tract and “menstruated” into the vagina, instead of rupturing into the abdomen and menstruating into the abdomen as perforating hemorrhagic (chocolate) cysts containing endometrial tissue are wont to do. It was Casler’s unique case that furnished the critical data that stimulated Sampson’s imagination and allowed him to make the intuitive leap from external ovarian “menstruation” to internal ovarian “menstruation” from a perforated hemorrhagic (chocolate) cyst into the abdomen, and the final intuitive leap to the deposition of endometrial tissue into the pelvis and the formation of pelvic adhesions.
4.
Novak, Emil. A Note on the History of Endometriosis. Undated. Current Medical Digest, page 52. Reference obtained from the Sampson Archives at the Albany Medical College. Year and volume are not available.
5.
James Conant and John Haugeland, “Editor’s Introduction.” in Kuhn, Thomas S. The Road Since Structure: Philosophical Essays, 1970–1993, with an Autobiographical Interview [Chicago, IL: University of Chicago Press, 2000], 3.
6.
James Conant and John Haugeland, “Editor’s Introduction.” in Kuhn, Thomas S. The Road Since Structure: Philosophical Essays, 1970–1993, with an Autobiographical Interview [Chicago, IL: University of Chicago Press, 2000], 1. “In The Structure of Scientific Revolutions, as nearly everyone knows, Thomas Kuhn argued that the history of science is not gradual and cumulative but rather punctuated by a series of more or less radical ‘paradigm shifts.’ What is less well known is that Kuhn’s own understanding of how best to characterize these episodes itself underwent a number of significant shifts.” Thomas S. Kuhn, “The Natural and the Human Sciences,” in Kuhn, Thomas S. The Road Since Structure: Philosophical Essays, 1970–1993, with an Autobiographical Interview, edited by James Conant and John Haugeland [ Chicago, IL: University of Chicago Press, 2000], 221. In this essay, Kuhn admitted that he seldom uses the term paradigm shift, “having totally lost control of it.”
7.
Casler DB. A unique, diffuse uterine tumor, really an adenomyoma, with stroma but no glands. Menstruation after complete hysterectomy due to uterine mucosa in remaining ovary. Transactions American Gynecological Society 1919;44:69–84.
8.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323. See also: Sampson JA. Perforating hemorrhagic (Chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Transactions American Gynecological Society 1921;46:162–241.
9.
Cullen TS. The distribution of adenomyomas containing uterine mucosa. Am J Obstetrics and Diseases of Women and Children 1919;180:130–138:135–6. Cullen commented on cases of uterine mucosa in ovaries reported by Russell, Norris, and Casler and implicitly invited others to investigate these lesions when he stated: “In due time a sufficient number of such cases will undoubtedly be reported and then we shall be able to give a composite picture of both the clinical course and of the histological changes that occur in this most unusual group of cases.” Cullen repeated this invitation in 1920. Cullen TS. The distribution of adenomyomas containing uterine mucosa. Archives of Surgery 1920;1:215–283:264. Cullen commented on the microscopic features seen in “a photomicrograph that I have had made from one of Dr. Schwarz’s sections…It is a beautiful example of an ovary containing miniature uterine cavities….From the foregoing it is evident that in due time a sufficient number of cases will undoubtedly be reported, and then we shall possibly be able to give a composite picture of both the clinical course and of the histologic changes that occur in this most unusual group of cases.”
10.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323:248. “Of physiologic interest, it is to be noted that the adenoma of endometrial type developing in the ovary and arising in the portion of the pelvis as the result of the escape of the hemorrhagic contents of the ovary may be the seat of periodic hemorrhages, i. e., they may be ‘menstruating organs’.”
11.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323:249. Sampson made a point of recording his early observations in 1910 and 1912, precise to the exact date he operated each of these early cases, May 8, 1910 and March 27, 1912, as well as the exact dates he operated his later patients.
12.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:291.
13.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:291. Sampson described Case 2. “Perforating hemorrhagic cysts of both ovaries; “adenomyoma” of the posterior wall of the uterus, adherent to and invading the anterior wall of the rectum.”
14.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:250. “On March 27 of that year [1912] I removed an ‘adenomyomatous’ uterus in which the ‘adenomyoma’ had apparently extended through the posterior uterine wall and had invaded the anterior wall of the rectum…On section, the ‘adenomyoma’ was apparently not connected with the uterine mucosa. Bilateral perforating hemorrhagic cyst of the ovary were present.”
15.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:292. Sampson described Case 3. “Perforating hemorrhagic cysts of both ovaries; adherent retroflexed uterus; adenoma of endometrial type invading the posterior wall of the uterus and uniting it with the anterior wall of the rectum.”
16.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:250.
17.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary Archives of Surgery 1921;3:245–323:250. For some reason Sampson seems to have skipped Case 4, operated October 11, 1917, and Case 5, operated February 7, 1918, in his story, but report them in his chronology of cases on pages 293 and 294, respectively. I believe the explanation lies with absence of satisfactory histology of the ovaries, none was attempted in Case 4, and in Case 5 only one microscopic section was taken from the ovarian cyst which “showed a cyst with its wall lined by low and cuboidal epithelium.” No sections were taken from the posterior wall of the uterus. In Case 6 operated June 13, 1918, Sampson observed: “Perforating hemorrhagic cyst of the right ovary; adherent retroflexed uterus; ‘adenomyoma’ of posterior uterine wall; gall stones.”
18.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:295.
19.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:250–51.
20.
As the title explicitly states, Sampson built this essay around gross pathology of the ovarian hematomas. He realized the full significance of chocolate cysts when he found they were partially or wholly lined by “tissue of the endometrial type” (page 247). Recognizing that ovarian cysts of this type might be “menstruating organs” (page 248), Sampson began systematic microscopic examinations of hemorrhagic ovarian cysts supplied by Emil Novak and then began microscopic examinations of his own material starting with Case 9 operated at the Albany Hospital on March 17, 1920 and continuing to his last case in this report, Case 23 operated on April 18, 1921.
21.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:251.
22.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:248. See Casler DB. A unique, diffuse uterine tumor, really an adenomyoma, with stroma, but no glands. Menstruation after complete hysterectomy due to uterine mucosa in remaining ovary. Transactions American Gynecological Society 1919;44:69–84. In 1919 Casler provided information decisive to the formation of Sampson’s initial theory of pathogenesis of pelvic endometriosis and pelvic endometriotic adhesions. Casler published a case report of an ovarian cyst which on microscopic examination was “made up almost entirely of uterine tissue.” Even more emphatically, Casler wrote of: “a large uterine growth of the ovary…the entire cyst, or uterine cavity, as it really is, is lined throughout by a single layer of tall columnar epithelium of the uterine type, and in places cilia can be made out.” Then Casler explained how regular “menstruation” could happen every month after total hysterectomy. “It is a natural process then that the uterine glands in the ovarian cyst should take on the active work of the uterus and maintain menstruation regularly.” In sum, Casler had presented a case of ovarian menstruation through the vagina: external ovarian menstruation. I believe Casler’s morphologic description and his physiologic reasoning planted the seed that led Sampson to imagine “internal ovarian menstruation.” I believe Sampson’s initial theory of the pathogenesis of pelvic endometriosis and pelvic endometriotic adhesions from perforating hemorrhagic (chocolate) cysts of the ovary was inspired by Casler’s observations.
23.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:255.
24.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:251–252.
25.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:253.
26.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:252.
27.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:248. I prefer the descriptive anatomical term rectovaginal pouch of Douglas to cul-de-sac which means literally – a blind diverticulum.
28.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:249.
29.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:249.
30.
Late in the twentieth century, Dr. Dan Martin and Professor Philippe R. Koninckx found that only in about 1 in 450 cases of deeply invasive endometriosis of the rectovaginal pouch of Douglas did the lesion actually invade through the floor of the rectovaginal pouch into the true anatomic rectovaginal septum of Denonvilliers. Personal communication from Dan Martin to Ronald E. Batt, October 20, 2007.
31.
Novak E. Hematomata of the ovary including corpus luteum cysts. Bulletin Johns Hopkins Hospital 1917;28:349–354.
32.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323:254.
33.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:247.
34.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:254.
35.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:255–256.
36.
Runge E. Ueber die Veranderunger der Ovarien bei Syncytralen Tumoren und Blasenmole; Zugleich ein Beitrag zur Histogenese. Arch f. Gynak. 1903;69:33–70.
37.
Wolf EH. Ueber Haematoma Ovarii. Arch f. Gynak 1908;84:211–243.
38.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323:256–257.
39.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:257.
40.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:257.
41.
Cuthbert Lockyer, Fibroids and Allied Tumours (Myoma and Adenomyoma): Their Pathology, Clinical Features and Surgical Treatment [London: Macmillan and Company, 1918]. In 1898, N.S. Iwanoff published his theory that glandular cystic spaces in fibromyomas originated by an ingrowth of overlying serosa. [Iwanoff NS. “Drusiges cystenhaltiges Uterusfibromyom compliciert durch Sarcom und Carinom.” Monatsschr fur Geb und Gynak 1898; Bd. vii: S. 295.] Iwanoff claimed that, in a paper published previously in Russia, he had demonstrated microscopically that glandular structures in an adenomyoma were derived from the serosal epithelium. (Lockyer pp 292–3) Iwanoff also believed the carcinoma he observed within the adenomyoma resulted from malignant changes within the adenomyoma. Accordingly he labeled the lesion Adeno-fibromyoma cysticum sarcomatodes carcinomatosum. This important paper of Iwanoff has been accepted as the origin of the theory of coelomic metaplasia. Later, Robert Meyer introduced the analogous concept of “epithelial heterotopy.” “Meyer showed as many other observers since have done, that epithelial heterotopy or displacement can occur in the serosa as well as in the mucosa.” (Lockyer: 293) Lockyer stated his own position [his italics] of the pathogenesis of extrauterine endometriosis: “Heterotopy of serosal epithelium is the probable explanation of the existence of the epithelial spaces and cysts in most of the extrauterine swellings found between the rectum and genital tract.” (Lockyer: 295) Lockyer contended that many reliable observers – without the possibility of doubt – had proved by “repeated investigations” the transformation of flattened “so-called ‘endothelium’ of the peritoneum” to be transformed into cylindrical and columnar epithelium under the excitation of inflammation or the influence of pregnancy. (Lockyer: 295, 299. Lockyer quotes from Klages R. Zeitschr fur Geb und Gynak 1912; Bd. lxx: S. 858. “that the transition of flat peritoneal epithelium into cubical or cylindrical can occur, has been repeatedly proved, and notably so by Opitz and Robert Meyer.” Lockyer states that “Opitz had found that where the peritoneum lies in natural folds, as it does at the tubal angles, the initial condition already exists for the down-growth of epithelial elements.”) Such a positive statement from an authority of the caliber of Lockyer serves to demonstrate the strength of the theory of coelomic metaplasia and its hold on medically sophisticated investigators of the World War I era. The theory of coelomic metaplasia was well established before Sampson began his investigations and would remain a powerful alternative to his theory of pathogenesis during his lifetime.
42.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323:258–259.
43.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:259–264.
44.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:261–262.
45.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:262.
46.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:263.
47.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:263.
48.
Michael Worboys, Spreading Germs: Disease Theories and Medical Practice in Britain, 1865–1900 [Cambridge, UK: Cambridge University Press, 2000], 6.
49.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary Archives of Surgery 1921;3:245–323:264.
50.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:263.
51.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:263.
52.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:266.
53.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:264.
54.
Savage S. Hematoma of the ovary and its pathological connection with the ripening and retrogression of the graafian follicle. Brit Gynaec J 1906;l21:285–305.
55.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:265.
56.
Hedley JP. Hematoma of the ovary with report of 18 cases. J Obstet Gynec Brit Empire 1910;18:293–311.
57.
In 1943, James Robert Goodall would describe in detail all the host responses to endometriosis.
58.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323:246. Sampson operated 14 cases between May 1, 1920 and May 1, 1921. The incidence was 14 cases in 178 operations. What first drew Sampson’s attention to the importance of perforating hemorrhagic (chocolate) cysts of the ovary was not only their frequency (p. 246), but more importantly the “nature of the adhesions resulting from the escape [of very irritating … chocolate] contents into the peritoneal cavity.” (pp. 245–6) The adhesive pattern reflected the effect of gravity within the pelvis: the “most extensive and densest adhesions [were] usually found in the culdesac uniting the supravaginal portion of the cervix and lower portion of the posterior wall of the uterus to the bottom of the culdesac and the anterior rectal wall.” (p. 246.)
59.
It is not by accident that Sampson placed the most severe disease in Pattern One. Most cases were severe.
60.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:268.
61.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary Archives of Surgery 1921;3:245–323:269.
62.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:269.
63.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:270.
64.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:271–272. See Figure 68, page 314 and Figure 70, page 316. Figure 70 (Case 22) is a low power photomicrograph of a bleb “lined by columnar cells resting on a cellular stroma” and filled with menstrual debris.
65.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:316. Figure 70 (Case 22).
66.
Cuthbert Lockyer, Fibroids and Allied Tumours (Myoma and Adenomyoma): Their Pathology, Clinical Features and Surgical Treatment [London: Macmillan and Company, 1918], 295, 296.
67.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323:272.
68.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:274.
69.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:274.
70.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary Archives of Surgery 1921;3:245–323:274.
71.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:275.
72.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:276.
73.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:276.
74.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:276.
75.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:277.
76.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:277.
77.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:277.
78.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:278.
79.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:319.
80.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323:279.
81.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:280.
82.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:319.
83.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:280.
84.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:281.
85.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:284.
86.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:281–282.
87.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:283.
88.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:284.
89.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:285.
90.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:285.
91.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:247.
92.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:253.
93.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:259.
94.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:272.
95.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary> Archives of Surgery 1921;3:245–323:279.
96.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:289, 300 and 308. See Figure 43 (Case 17) on page 289, Figure 54 (Case 19) on page 300, and Figure 60 (Case 12) on page 306.
97.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:298.
98.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323:301.
99.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:314.
100.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:316.
101.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:285.
102.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:285–286.
103.
Cuthbert Lockyer, Fibroids and Allied Tumours (Myoma and Adenomyoma): Their Pathology, Clinical Features and Surgical Treatment [London: Macmillan and Company, 1918].
104.
Sampson JA. Intestinal adenomas of endometrial type: their importance and their relation to ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary). Archives of Surgery 1922;5:217–280;224–225.
105.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323:287.
106.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:287.
107.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:287–288.
108.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:287.
109.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:287–288.
110.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323:289.
111.
Clement, PB. History of Gynecologic Pathology IX: Dr. John Albertson Sampson. International Journal of Clinical Pathology 2001;20:86–101. In the bibliography of Sampson’s works following this scholarly biographical essay, Clement lists many articles of Sampson that pertain to radical surgery for cervical cancer and to the pathology of cervical cancer.
112.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:289–290.
113.
U. S. Department of Health and Human Services Centers for Disease Control and Prevention: National Center for Health Statistics, National Vital Statistics System. United States Life Tables, 2004. National Vital Statistics Reports: Volume 56, Number 8, December 28, 2007, Page 30. Table 11. Life expectancy by age, race, and sex: Death-registration states, 1900–1902 to 1919–1921, and United States, 1929–1931 to 2004.
114.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:290.
115.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:290.
116.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:290–291.
117.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:291.
118.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323:322–323.
119.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Archives of Surgery 1921;3:245–323:323. Nowhere in this paper did Sampson mention transtubal menstrual dissemination of endometrial tissue into the peritoneal cavity.
120.
Janney JC. Report of three cases of a rare ovarian anomaly. Am J Obstet Gynecol 1922;Feb:173–187.
121.
Janney JC. Report of three cases of a rare ovarian anomaly. Am J Obstet Gynecol 1922;Feb:173–187: 187.
122.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary. Am J Obstet Gynecol 1921: 2:526–33. Note the discussion of his paper delivered at the American Gynecological Society meeting was published in the American Journal of Obstetrics and Gynecology while his paper was published in the Archives of Surgery in 1921 and also in the Transactions of the American Gynecological Society in 1921, in the later instance with the addition of a historical note of great importance.
123.
Sampson JA. Heterotopic or misplaced endometrial tissue. Am J Obstet Gynecol 1925;10:649–664:655. Pick L. Arch f Gynaek 1905;lxxvi:251–275. Sampson was referring to Meigs who initiated the use of the term “(Sampson’s cyst),” and undoubtedly others. See Meigs JV. Endometrial hematomas of the ovary. Boston Med Surg J 1922;clxxxvii:1–13:10, 12.
124.
Pick L. Arch f Gynaek 1905;lxxvi:251–275:261–262. “Ein- oder mehrfache im Ovarium verstreute Cysten mit syrupos-blutigem, chocoladenbraunem oder rothlichem Inhalt und schleimhautahnlicher pigmentirter Auskleidug weisen makroskopisch auf diese Form des Adenomas, das ein Adenoma oder Cystadenoma ovarii vom Bau des Endometrium corporis uteri darstellt und kaum einen treffenderen Namen erhalten kann als den eines Adenoma endometroides ovarii).1” [Footnote 1] “Vielleicht ist diese Geschwulstform identisch mit dem alten Rokitansky-schen Cystosarcoma adenoides ovarii uterinum. Lehrb. D. pathology. Anatom. III. Aufl. Bd. III. 1861. Wien. S. 423, S431.” On examination of a copy of Rokitansky’s contribution: Lehrbuch der Pathologischen Anatomie 1855–61. III:475–490, reference to page S 431 is actually a reference to a running heading at the top of page 475 and reads “Rokitansky Uterusdrüsen – Neubildung. 1. c. (S. 431).” Since the copy I possess runs from pp. 475–490, I do not have the earlier pages which would contain the reference to S. 23.
125.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Transactions of the American Gynecological Society 1921;46:162–241:235–6.
126.
K. Codell Carter, The Rise of Causal Concepts of Disease: Case Histories [Burlington, VT: Ashgate, 2003], 106. See also pages 199 and 200. “Between about 1830 and 1880, medicine reorganized itself around the concept of universal necessary causes…The etiological research programme [achieved an] enormous increase in explanatory power.”
127.
K. Codell Carter, The Rise of Causal Concepts of Disease: Case Histories, 107.
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Sampson JA. Ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) and implantation adenomas of endometrial type. Boston Medical and Surgical Journal 1922;186:445–56.
129.
Sampson, JA. Ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) and implantation adenomas of endometrial type. Boston Med Surg J 1922;186:445–456.
130.
Meigs, JV. Endometrial hematomas of the ovary. Boston Med Surg J 1922:187:1–13.
131.
Sampson JA. Boston Med Surg J 1922;186:445–456.
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Sampson JA. Ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) and implantation adenomas of endometrial type. Boston Med Surg J 1922;186:445.
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Sampson JA. Boston Med Surg J 1922;186:445–456;445.
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Sampson JA. Boston Med Surg J 1922;186:445–456:446.
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Sampson JA. Boston Med Surg J 1922;186:445–456:447.
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Halban J. Hysteroadenosis metastatica. (Die lymphogene Genese der sog. Adenofibromatosis heterotopica.) Wiener klinische Wochenschrift 1924;37:1205–6.
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Sampson JA. Ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) and implantation adenomas of endometrial type. Boston Med Surg J 1922;186:445–456:448.
140.
Sampson JA. Boston Med Surg J 1922;186:445–456:455.
141.
Sampson JA. Boston Medical and Surgical Journal 1922;186:445–456.:456.
142.
Sampson JA. Ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) and implantation adenomas of endometrial type. Boston Medical and Surgical Journal 1922;186:445–456:456.
143.
Sampson JA. Boston Med Surg J 1922;186:445–456:456.
144.
Sampson JA. Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type (“Adenomyoma” of the uterus, rectovaginal septum, sigmoid, etc.) Archives of Surgery 1921;3:245–323.
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Meigs, JV. Endometrial hematomas of the ovary. Boston Med Surg J 1922:187:1–13:1
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Meigs, JV. Boston Med Surg J 1922:187:1–13:2.
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Meigs, JV. Boston Med Surg J 1922:187:1–13:2.
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Meigs, JV. Boston Med Surg J 1922:187:1–13:6.
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Meigs, JV. Boston Med Surg J 1922:187:1–13:1. Endothelial leucocytes are part of the innate immune system operative at birth. See: Richardson AC, Carpenter MW. Inflammatory mediators in gestational diabetes mellitus. Obstet Gynecol Clin N Am 2007;34:213–224:216.
“The immune system defends its host against both external threats, such as bacterial infection, viral infection; physical injury, and internal threats such as malignant transformation. The immune system has historically been divided into two parts: the innate and adaptive. They are separated purely for descriptive purposes and are not mutually exclusive of one another. From an evolutionary standpoint, the innate immune system predates the adaptive immune system. The innate immune system is considered to be the ‘first-line’ of defense against microbes or tissue damage. The adaptive immune system is activated by the innate immune system and responds to antigens to which the organism has already been exposed, thereby providing the ability to mount a more effective response.”
150.
Meigs, JV. Endometrial hematomas of the ovary. Boston Med Surg J 1922:187:1–13.
151.
Meigs, JV. Boston Med Surg J 1922:187:1–13:3.
152.
Janney JC. Report of three cases of a rare ovarian anomaly. Am J Obstet Gynecol 1922;Feb:173–187:180.
153.
Janney JC. Report of three cases of a rare ovarian anomaly. Am J Obstet Gynecol 1922;Feb:173–187:181.
154.
Janney JC. Am J Obstet Gynecol 1922;Feb:173–187:182–184.
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Janney JC. Am J Obstet Gynecol 1922;Feb:173–187:187.
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Faulconer RJ. Observations on the origins of the müllerian groove in human embryos. Contrib Embryol 1951;229:161–164:161.
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Ludwig KS. The Mayer-Rokitansky-Küster syndrome. An analysis of its morphology and embryology. Part II: embryology. Arch Gynecol Obstet 1998;262:27–42.
158.
Batt RE. Mhawech-Fauceglia P, Odunsi K, Yeh J. Pathogenesis of mediastinal paravertebral müllerian cysts of Hattori: developmental endosalpingiosis-müllerianosis. Int J Gynecol Pathol 2010;29:546–561.
159.
Meigs, JV. Endometrial hematomas of the ovary. Boston Med Surg J 1922:187:1–13:4, 3.
160.
Meigs, JV. Boston Med Surg J 1922:187:1–13:4.
161.
Sampson JA. Benign and malignant endometrial implants in the peritoneal cavity, and their relation to certain ovarian tumors. Surg Gynecol Obstet 1924;38:287–311.
162.
Sampson JA. Intestinal adenomas of endometrial type: their importance and their relation to ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) Archives of Surgery 1922;5:217–280:218.
163.
Sampson JA. Intestinal adenomas of endometrial type. Archives of Surgery 1922;5:217–280:261. For the first time Sampson refers to his “theory.” “This theory as to the origin of these ovarian hematomas and also their relation to endometrial implantations is based on the following data.”
164.
Sampson JA. Intestinal adenomas of endometrial type. Archives of Surgery 1922;5:217–280.
165.
Sampson JA. Intestinal adenomas of endometrial type. Archives of Surgery 1922;5:217–280:261–262. Regarding size of ovarian hematomas of endometrial type, see pages 217–8. “The size of these hematomas was described in the previous paper as being usually between 2 and 4 cm. in diameter, occasionally less than 2 cm. and also occasionally larger than 4 cm. … I would modify the foregoing statement in regard to the size by adding that they are often so small and inconspicuous that they may be easily missed both at the time of the operation and in the pathology laboratory.”
166.
Sampson JA. The development of the implantation theory for the origin of peritoneal endometriosis. Am J Obstet Gynecol 1940;40:549–557.
167.
The historian analyzing prospectively runs into similar problems encountered by the clinician and scientist analyzing prospectively.
168.
Sampson JA. Am J Obstet Gynecol 1940;40:549–557:555.
169.
Sampson JA. Intestinal adenomas of endometrial type: their importance and their relation to ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) Archives of Surgery 1922;5:217–280:277.
170.
Sampson JA. Intestinal adenomas of endometrial type: their importance and their relation to ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) Archives of Surgery 1922;5:217–280:240. See Figure 27 (case 8) on page 240. This is a good illustration of the kinking of the sigmoid colon cause by implantation adenomas of the sigmoid colon.
171.
Sampson JA. Archives of Surgery 1922;5:217–280:277. See also: 218, 225. See Figure 59 (Case 12) This excellent illustration shows the ileum adherent to an adenoma of the posterior uterine fundus. The caption gives Sampson’s interpretation of the pathogenesis of the lesion. “My interpretation of the etiology of this condition is as follows. At the previous operation, 4 years ago, some of the epithelium lining the hemorrhagic cyst of the left ovary became implanted on the posterior surface of the uterus and other portions of the pelvic contents and developed into implantation adenomas of endometrial type. The ileum became adherent to the implantation on the posterior surface of the uterus and was superficially invaded by it. The uterine wall was invaded to a much greater extent as indicated.”
172.
Sampson JA. Archives of Surgery 1922;5:217–280:278.
173.
Sampson JA. Archives of Surgery 1922;5:217–280:278. Hypertrophy of surrounding tissues is a good example of the host response to the intrusion of the “tubules” of the adenoma.
174.
Sampson JA. Intestinal adenomas of endometrial type: their importance and their relation to ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) Archives of Surgery 1922;5:217–280. See Figure 42 (Case 2) on page 251. “Section of the wall of the sigmoid which was excised. It shows a typical adenoma of endometrial type. The implantation apparently began on the peritoneal surface, possibly through an epiploic appendage, indicated by the arrow, and invaded the subserosa and then wormed its way through the muscularis forming hematomas.” See also Figure 46 (Case 1) on page 254. “Section of the wall of the sigmoid showing an adenoma of endometrial type invading it…The adenoma first invaded the subserosa and then wormed its way through the muscularis forming a hematoma.”
175.
Sampson JA. Intestinal adenomas of endometrial type: their importance and their relation to ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) Archives of Surgery 1922;5:217–280:252. See Figure 43 (Case 2) “A small uterine cavity found in a section of the wall of the sigmoid.”
176.
Sampson JA. Archives of Surgery 1922;5:217–280:278. See Figure 44 (Case 2) on page 252. “Endometrial polyp invading a lymph vessel in the submucosa of the sigmoid. These polyps are frequently found in implantation adenomas of endometrial type.” See also Figure 45 (Case 2) on page 253. “Implantation adenoma (a) on the surface of the broad ligament and invading a lymph vessel in the broad ligament. Two endometrial polyps (e, p) are shown, the large one came from the adenoma (b) of this illustration. The invasion of the lymph vessels by these adenomas suggests that they may metastasize through these channels and offers one explanation for the appearance of adenoma in the groin.” Here Sampson has identified endometrial invasion of lymph vessels 2 years before Halban published his theory of lymphatic metastases in 1924.
177.
Sampson JA. Archives of Surgery 1922;5:217–280:279.
178.
Sampson JA. Archives of Surgery 1922;5:217–280:243–4.
179.
Sampson JA. Archives of Surgery 1922;5:217–280:227–9.
180.
Sampson JA. Archives of Surgery 1922;5:217–280:279.
181.
Sampson JA. Archives of Surgery 1922;5:217–280:279.
182.
Sampson JA. Intestinal adenomas of endometrial type: their importance and their relation to ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) Archives of Surgery 1922;5:217–280:280. See also Figure 10 (case 4) page 226. “I believe that this adenoma of the uterus did not arise from the direct invasion of the uterine mucosa of the uterine cavity or from developmental inclusions of müllerian epithelium or from a metaplasia of the peritoneal mesothelium; but I believe it arose from the implantation of epithelium from the lining of a hemorrhagic cyst of the ovary which had perforated.”
183.
Sampson JA. Archives of Surgery 1922;5:217–280:280. Note how often Sampson mentions tubal epithelium. See text page 258. “The data which I have been able to obtain suggest that tubal and uterine epithelial cells may, under certain circumstances (as an abnormal menstruation with a backflow), be expelled from the fimbriated end of the tube and lodge on the surface of the ovary.”
184.
Sampson JA. Archives of Surgery 1922;5:217–280:258–9.
185.
Sampson JA. Archives of Surgery 1922;5:217–280:224–225. See also Figure 9 (Case 4) page 226. “Photomicrograph of an implantation adenoma (of endometrial type) on the surface of the left tube…Histologically it resembles normal endometrium. It is analogous to the implantation carcinoma shown in Figure 2.” (page 220).
186.
Sampson JA. Archives of Surgery 1922;5:217–280:242. See Figure 29 (Case 8) on page 242. “Implantation adenoma invading the wall of the uterus. Photomicrograph of a portion of the uterine wall through one of the pits. The arrow indicates the bottom of the pit between the adhesions. The adenoma on the surface of the uterus is here shown invading the wall of the uterus.” See also Figure 30 (Case 8) page 242. “Implantation adenoma on the surface of the uterus. The photomicrograph shows a polypoid condition of the endometrium lining the bottom of a wide pit which has been exposed by freeing the uterus from the adherent sigmoid colon.” Finally, see Figure 60, page 271. “Adenoma of endometrial type of the posterior uterine wall and superficially invading the wall of the ileum which is fused to the uterus at this place…It only superficially invaded the wall of the intestine but has extensively invaded the uterine wall, giving rise to a typical so-called adenomyoma of the uterus, not arising from the direct invasion of the uterine mucosa from the uterine cavity or from the developmental inclusions of müllerian epithelium in the uterine wall or from a metaplasia of the peritoneal mesothelium but from the implantation of endometrial epithelium from the epithelia lining of a perforated hemorrhagic cyst of the ovary (of endometrial type), as probably the majority of the ectopic pelvic adenomyomas (of endometrial type) shown in this and the previous communication arose.”
187.
Sampson JA. Archives of Surgery 1922;5:217–280:279. Ibid: 249.
188.
Sampson JA. Intestinal adenomas of endometrial type: their importance and their relation to ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) Archives of Surgery 1922;5:217–280:279.
189.
Sampson JA. Archives of Surgery 1922;5:217–280:217.
190.
Sampson JA. Archives of Surgery 1922;5:217–280:219–220.
191.
Sampson JA. Archives of Surgery 1922;5:217–280:222. See Figure 4 (Case 4).
192.
Sampson JA. Archives of Surgery 1922;5:217–280:230. See Figure 14 (case 5). See also Ronald E. Batt, “Conservative and complete operations by laparotomy,” in Text and Atlas of Female Infertility Surgery, ed. Robert B. Hunt, 3^rd ed. [St. Louis, MO: Mosby, 1999], 412–439:424–5. “As reproductive surgeons treat increasingly severe cases of endometriosis they encounter the left-frozen pelvis. A large ovarian endometrioma is fused to the broad ligament and ureter, with the oviduct sandwiched between the ovary and broad ligament, or adherent to tubal or antimesenteric border of the ovary, and the whole completely enveloped by sigmoid colon in obliterative adhesive disease.”
193.
Sampson JA. Archives of Surgery 1922;5:217–280:239. See Figure 26 (case 8) page 239.
194.
Sampson JA. Intestinal adenomas of endometrial type: their importance and their relation to ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary) Archives of Surgery 1922;5:217–280:234 See Figure 19 (case 10) on page 234. The completely frozen pelvis with centripetal adherence of all pelvic organs to the uterus is the most devastating form of pelvic adenomata of endometrial type from the viewpoint of the infertile couple. Ronald E. Batt, “Abdominopelvic diagnostic laparoscopy,” in Text and Atlas of Female Infertility Surgery, ed. Robert B. Hunt, 3^rd ed. [St. Louis, MO: Mosby, 1999], 372–385:376–377. Complex disease patterns: (1) Partial and complete obliteration of the rectovaginal pouch. “Partial obliteration of the rectovaginal pouch usually indicates deep, nodular, invasive disease of one uterosacral ligament and sometimes of pararectal or rectal tissue adherent to it. Complete obliteration usually is associated with deep, nodular, invasive disease of both uterosacral ligaments, posterior cervix, and rectum…Centrifugal pattern: The predominant pattern of endometriosis is centrifugal, with adnexa adherent laterally to posterior broad ligaments with or without obliterative disease of the rectovaginal pouch … Centripetal: The centripetal pattern is a less common but more severe form of disease. The uterus is retroflexed, retroverted, and adherent to itself and to the rectum, with complete obliteration of the rectovaginal pouch and adherence of both ovaries to the posterior uterus and side of the rectum…Left frozen pelvis: This pattern is characterized by a large ovarian endometrioma fused to the broad ligament over the ureter, with the oviduct adherent between the ovary and broad ligament or adherent to the tubal pole and antimesenteric border of the ovary, and the whole enveloped by the sigmoid colon in dense obliterative adhesions. It develops spontaneously when the sigmoid colon envelops the left adnexa to contain chocolate debris from repeated ruptures of left ovarian endometriomas. It also may develop in response to surgical intervention. In both instances, the left adnexa often is damaged irreparably. Intravenous pyelogram is recommended to detect partial or complete obstruction of the left ureter.,,, Complete frozen pelvis: Frozen pelvis represents the most complex and severe pattern. It is the final expression of aggressive endometriosis, impaired host immune defenses, and often numerous attempts at medical and surgical treatment. The patient’s health may be threatened.”
195.
Sampson JA. Archives of Surgery 1922;5:217–280. See Figure 18 (Case 5), page 233. Sagittal section of the myomatous uterus and adjacent pelvic structures indicating the condition present prior to the operation. The adenoma of endometrial type is shown fusing the cervix to the rectum and superficially invading these structures. Also illustrated is a sagittal section of a hematoma of the left ovary. See also Figure 25 (Case 10) page 238. “Condition prior to the operation, as seen in sagittal section of the uterus and adjacent structures. The implantation adenoma lodging and growing in the culdesac has invaded both the uterus and the rectum fusing these parts, and has extended downward between the rectum and the vagina to the right of the cervix (the perforated hematoma was in the right ovary) forming a tumor which could be distinctly felt before operation both on vaginal and rectal palpation.” See also Figure 41 (Case 2) on page 250.

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State University of New York at Buffalo, Buffalo, New York, USA
Ronald E. Batt M.D., Ph.D. (Professor of Gynecology)

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Ronald E. Batt M.D., Ph.D.
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Batt, R.E. (2011). Sampson’s Theory of Implantation Endometriosis. In: A History of Endometriosis. Springer, London. https://doi.org/10.1007/978-0-85729-585-9_8

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