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Hypothesized pathogenesis of inguinal endometriosis. The abdominal fluid containing endometrial cells circulates clockwise in the abdominal cavity, and the sigmoid colon blocks the abdominal fluid from entering the left inguinal ring. As a result, the intraperitoneal fluid is more likely to enter the right inguinal ring than the left. Endometriosis also propagates from the pelvis to the groin via the round ligament (brown dot arrow)
