Disseminated endometriosis of the urinary, genital and intestinal syst
ems was treated successfully with conservative surgery. We hypothesize
that this unusual presentation may have derived from retrograde menst
ruation, pooling of endometrial cells in the dependent anterior and po
sterior cul-de-sacs with subsequent passage across the peritoneal meso
thelium, and dissemination by clockwise intraabdominal currents.