Intraperitoneal India ink deposits appearing as endometriosis in a patient with chronic pelvic pain.
BACKGROUND
Visualization and biopsy of suspicious peritoneum can confirm endometriosis. Endoscopic India ink tattooing can lead to peritoneum that visually mimics endometriosis.


METHODS
A woman with chronic pelvic pain and a history of treated endometriosis underwent diagnostic laparoscopy. Previously, a small bowel endoscopy had been performed to evaluate the pain. At laparoscopy, black peritoneal lesions were seen and biopsied due to concern for endometriosis. Pathology concluded the lesions to be carbon-based ink. Investigation revealed that tattoos placed during the small bowel endoscopy used India ink.


CONCLUSIONS
Endoscopic India ink tattooing used to demarcate an area of bowel for later identification can stain peritoneal surfaces and mimic endometriotic implants.
Algoe
Kristin K
KK
Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Departments of Obstetrics and Gynecology and Pathology, Lebanon, NH 03756, USA. kristin.k.algoe@hitchcock.org
Chen
Hui
H
Schned
Alan R
AR
Whiteside
James L
JL
D002244:Carbon; D003951:Diagnostic Errors; D004715:Endometriosis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D017699:Pelvic Pain / Q000175:diagnosis*; D013653:Tattooing
C028433:chinese ink; D002244:Carbon