Preoperative double-contrast barium enema in patients with suspected intestinal endometriosis

Stefano Landi, Barbieri F, Fabrizio Barbieri, F Barbieri, Andrea Fiaccavento, Fiaccavento A, Mainardi P, Paride Mainardi, Ruffo G, Giacomo Ruffo, Luigi Selvaggi, Selvaggi L, Syed R, Radha Syed, Luca Minelli, Minelli L
The Journal of the American Association of Gynecologic Laparoscopists · 2004 · vol. 11(2) , pp. 223–228 · doi:10.1016/s1074-3804(05)60203-4 · PMID:15200779 · W2141751953
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This study evaluated the diagnostic accuracy of preoperative double-contrast barium enema for identifying intestinal endometriosis.

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Abstract

STUDY OBJECTIVES: To assess the usefulness of double-contrast barium enema (DCBE) in the diagnosis of endometriotic lesions of the bowel and to define its potential value in preoperative decision making for intestinal surgery. DESIGN: Retrospective study (Canadian Task Force classification II-2). SETTING: General hospital with a specialized endometriosis unit. PATIENTS: One hundred and eight women with symptoms suggestive of intestinal endometriosis who underwent DCBE before laparoscopic surgery. INTERVENTION: Laparoscopic complete excision of endometriosis. MEASUREMENTS AND MAIN RESULTS: Fifty-five patients were found to have an entirely normal colon on DCBE studies. Twenty-eight of these were found to have adhesions of the bowel at laparoscopy. Radiographic abnormalities suggestive of endometriosis were detected in 53 patients; 20 of these underwent laparoscopic bowel segmental resection, 10 laparoscopic full-thickness disc excision, 4 laparoscopic mucosal skinning, and 4 total laparoscopic hysterectomy with bilateral salpingo-oophorectomies. Fourteen patients refused intestinal surgery. One patient had no endometriosis but severe adhesions. In all cases but one, the radiographic findings on DCBE were confirmed by surgery and with histopathologic examination of the resected specimens (accuracy 99%). In these same cases, the preoperative choice of intestinal surgery remained unchanged during the procedure. CONCLUSION: Our data show that, in expert hands, DCBE correlated with a patient's clinical history and clinical findings is capable of diagnosing bowel wall involvement due to endometriosis, which could require intestinal surgery. This allows for proper preoperative planning of surgical procedures and a thorough informed consent.

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Condition tags

endometriosis

MeSH descriptors

Barium Sulfate Barium Sulfate Endometriosis Endometriosis Enema Intestinal Diseases Intestinal Diseases Adult Adult Case-Control Studies Case-Control Studies Contrast Media Contrast Media Endometriosis Endometriosis Enema Enema Female Female Follow-Up Studies

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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