How does endometrial obstruction return a responsibility?

summary

Under normal circumstances, the endometrium covers the surface of the uterine cavity. If the endometrium grows in other parts of the body due to certain factors, it can become endometriosis. Histologically, the ectopic endometrium is surrounded by not only the glands but also the stroma; There are obvious changes in function with the level of estrogen, that is, with the menstrual cycle, but only part of the pregnancy hormone can produce a small amount of "menstruation" and cause a variety of clinical phenomena. If the patient is pregnant, the ectopic endometrium may have decidual changes. Although the ectopic endometrium grows in other tissues or organs, it is different from the invasion of malignant tumor. The peak age of the disease is 30-40 years old. The actual incidence of endometriosis is far more than that seen clinically. About 20-25% of the patients have ectopic endometrium, which can be found by laparotomy for other gynecological diseases and pathological examination of excised uterine appendages. How does endometrial obstruction return a responsibility? Come and study with me.

How does endometrial obstruction return a responsibility?

The first reason: planting theory was the earliest (1921). Some people believed that the occurrence of pelvic endometriosis was caused by the endometrial debris flowing with the blood, entering the pelvic cavity through the fallopian tube and planting in the ovary or other parts of the pelvic cavity. Clinically, menstrual blood and endometrium can be found in pelvic cavity during laparotomy during menstrual period. Abdominal scar endometriosis after cesarean section is a good example of implantation theory.

Reason 2: serous membrane theory, also known as metaplasia theory, holds that ovarian and pelvic endometriosis is metaplasia of mesothelial cell layer of peritoneum. The accessory mesonephric duct is derived from the primitive peritoneal invagination. It is differentiated from the body cavity epithelium, such as the germinal epithelium of ovary, pelvic peritoneum, atresia peritoneal invagination, such as the peritoneal sheath (nuke's canal), rectovaginal septum, umbilicus, etc.

The third reason: immunology theory, reported by weed et al. In 1980, there were lymphocytes and plasma cells infiltration around ectopic endometrium, hemosiderin deposition and fibrosis in macrophages. They believe that the ectopic endometrial lesions as foreign bodies, activated the body's immune system. Since then, many scholars have explored the etiology and pathogenesis of endometriosis from the aspects of cellular immunity and humoral immunity.

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