Rectal endometriosis: high sensitivity and specificity of endorectal ultrasound with an impact for the operative management

Doniec, J. M.; Kahlke, Volker; Peetz, Frederik; Schniewind, Bodo; Mundhenke, Christoph; Löhnert, Matthias S.; Kremer, Bernd

doi:10.1007/bf02660773

Cited by 40 publications

(34 citation statements)

References 13 publications

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“…This has better sensitivity and specificity than computed tomography (CT) and nuclear magnetic resonance (NMR). 14 The differential diagnoses of colonic lesions include adenocarcinomas, sarcomas, lymphomas, carcinomas and intestinal endometriosis. 5 In cases of intestinal endometriosis, the need for colectomy ranges from 0.1 to 0.7% of the cases 8 since the rate of endometrial carcinomas in ectopic endometrial tissue is very low.…”

Section: Discussionmentioning

confidence: 99%

Postmenopausal intestinal obstructive endometriosis: case report and review of the literature

et al. 2008

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CONTEXT: Endometriosis is characterized by the presence of endometrial tissue outside the uterine cavity, which is commonly detected in gynecological practice but rarely reported as a coloproctological disorder. The objective of the present report was to discuss a rare case of postmenopausal intestinal endometriosis simulating a malignant lesion, following a review of the literature. CASE REPORT: A 74-year-old woman with complaints of hematochezia and tenesmus of two months' duration accompanied by liquid feces and pelvic pain, but with no other gastrointestinal or gynecological complaints, was referred to our service. She had been menopausal for 22 years, with no hormone replacement treatment, and had undergone panhysterectomy three years before the referral to us, due to endometrial thickening and a right adnexal cyst. Five months before this referral, she had undergone laparotomy due to acute obstructive abdomen, which revealed a tumor mass involving the small bowel. Anatomopathological examination of the enterectomy suggested a hypothesis of intestinal endometriosis. A proctological examination was normal. Computed tomography of the pelvis revealed thickening of the rectosigmoid transition and colonoscopy revealed friable tumor formation in the rectum. A biopsy of the lesion revealed mucosal fragments of endometrial type, which led to a review of the previous anatomopathological examination. The patient underwent rectosigmoidectomy with protective transversotomy, with a good postoperative course, and anatomical examination confirmed the intestinal endometriosis. The patient subsequently suffered a stenosing recurrence of the lesion and has undergone colostomy since then.

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Section: Discussionmentioning

confidence: 99%

Postmenopausal intestinal obstructive endometriosis: case report and review of the literature

et al. 2008

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“…Pri diagnosticiranju endometrioze danke in sigmoidnega kolona se je s skoraj 100-odstotno občutljivostjo uveljavila kombinacija transvaginale in endorektalne ultrazvočne preiskave (7,8). Medikamentno zdravljenje GIE praviloma ni učinkovito (9), zato je za enkrat izbirni način zdravljenja endometrioze črevesa kirurški z vedno bolj uveljavlje-nim laparoskopskim pristopom (10,11).…”

Section: Uvodunclassified

“…Vzrokov za naraščanje števila resekcij črevesa je več: vse večja ozaveščenost o bolezni in zgodnejša diagnostika, sodobni minimalno invazivni diagnostični postopki (7,8) kakor tudi število kirurgov, usposobljenih za minimalno invaziven laparoskopski kirurški pristop.…”

Section: Razpravljanjeunclassified

Kakovost življenja pred in po laparoskopski resekciji črevesa zaradi globoke infiltrativne endometrioze

2017

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Background: Te purpose of the study was to determine the quality of life in patients with bowel endometriosis before and afer laparoscopic bowel resection.Material and methods: In the retrospective study we included 91 patients who underwent laparoscopic resection of the bowel aﬀected by endometriosis at the Unit for Reproduction and the Unit for Gynecology, Department of Obstetrics and Gynecology Ljubljana, in the period from 2002 to 2011. Te study was retrospective. Te patients were sent a questionnaire regarding the symptoms before surgery and the eﬀect of surgery on bowel symptoms, painful menstruation, painful sexual intercourse, chronic pelvic pain and quality of life before and afer surgery; 76 (83.5 %) patients replied to the questionnaire.Results: Before surgery, 72 (94.7 %) patients reported painful menstruation. Improvement or complete relief afer surgery was registered in 57 (79.1 %). Out of 60 (78.9 %) patients who had painful sexual intercourse before surgery, 49 (81.7 %) reported improvement or complete relief afer surgery. Bowel symptoms, present in 52 (68.4 %) patients before surgery, improved or completely disappeared in 48 (92.4 %) afer surgery. Chronic pelvic pain, present in 53 (69.7 %) before surgery, decreased or did not exist any more in 45 patients (86.5 %). Te quality of life before surgery was very poor in 32 patients (42.1 %), and poor in 21 patients (27.8 %). Afer the operation, the quality of life was reported as improved in 22 (28.9 %) and signifcantly improved in 42 (55.3 %).Conclusions: Laparoscopic bowel resection, indicated in extensive symptomatic endometriosis, signifcantly improves the patients’ quality of life.

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“…There are only few exclusive studies evaluating the use of endo-rectal ultrasound in diagnosis and staging of rectosigmoid endometriosis [14,16,19,[27][28][29][30][31][32][33][34][35][36] ; they are presented in Table 1. Almost all are retrospective studies, and they have the limitation to be widely disparate in terms of purposes studied, and technical devices tested.…”

Section: Exclusive Endo-rectal Ultrasound Studiesmentioning

confidence: 99%

“…Actually, and this is consistent with most author's descriptions, endorectal ultrasound examination can localize USL clearly, only when it is already infiltrated by endometriosis. Globally, when trying to answer to the question of the presence (or not) of endometriotic recto-sigmoid parietal infiltration, short series available, most of them published between 1998 and 2008 [14,22,[28][29][30][31][32][33][34] , show close sensitivities and negative predictive values, as well as with blind and endoscopic probes. Comparison of Delpy and Bahr's studies, clearly illustrates this conclusion [32,33] .…”

Section: Exclusive Endo-rectal Ultrasound Studiesmentioning

confidence: 99%

Recto-sigmoid endoscopic-ultrasonography in the staging of deep infiltrating endometriosis

Roseau¹

2014

WJGE

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Recto-sigmoid endoscopic ultrasonography (RS-EUS) has first been used in the staging of pelvic deep infiltrating endometriosis in the early 1990's. Since then, although publications have been sparse, RS-EUS is routinely used for this indication in few centers. In this paper, we focus on technical aspects and operating method of rectal and sigmoid endo-sonography, and describe the most characteristic echographic presentations of endometriosis of the lower digestive tract. Through a literature review, results obtained with different types of endo-rectal probes, either flexible endoscopic, or blind rigid, are presented and compared with those of other close imaging techniques: magnetic resonance imaging and the more recent trans-vaginal sonography. As well as these two latter techniques, RS-EUS appears as an interesting method in the staging of pelvic deep infiltrating endometriosis particularly to evaluate rectal and sigmoid infiltrations. However, more prospective studies are required, to correctly define respective indications for each exam, in the light of recent advancements in treating this frequent disease. Key words: Endometriosis; Rectum and sigmoid; Ultrasound; Endoscopic-ultrasonography; Surgical treatment; Magnetic resonance imaging Core tip: Pelvic deep infiltrating endometriosis is a disabling disease of increasing rate. Today new medical and surgical therapies are proposed in the management of pain and infertility, and the choice of an optimal treatment strategy requires a precise anatomic evaluation. Several imaging techniques are available, either additive or competitive, in this staging. Rectosigmoid endoscopic-ultrasonography (RS-EUS), is routinely used in the field of gastroenterology, mostly for staging of rectal cancer. Few studies have demonstrated it could also be of interest to image endometriotic rectosigmoid infiltrations. In this review, we tried to assess indications and results of RS-EUS, compared to those of magnetic resonance imaging and transvaginal sonography.Roseau G. Recto-sigmoid endoscopic-ultrasonography in the staging of deep infiltrating endometriosis. World J Gastrointest

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Rectal endometriosis: high sensitivity and specificity of endorectal ultrasound with an impact for the operative management

Cited by 40 publications

References 13 publications

Postmenopausal intestinal obstructive endometriosis: case report and review of the literature

Postmenopausal intestinal obstructive endometriosis: case report and review of the literature

Kakovost življenja pred in po laparoskopski resekciji črevesa zaradi globoke infiltrativne endometrioze

Recto-sigmoid endoscopic-ultrasonography in the staging of deep infiltrating endometriosis

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