Complicações da endometriose intestinal infiltrativa profunda

In: Research, Society and Development · 2024 · vol. 13(5) , pp. e1013545677 · doi:10.33448/rsd-v13i5.45677 · W4396747674
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This review of literature on deep infiltrative intestinal endometriosis identified primary symptoms including pelvic pain and varied intestinal issues, with constipation and infertility being critical complications.

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This paper is a literature review describing the complications caused by deep infiltrating intestinal endometriosis (DIE), including the symptom profile and which intestinal regions are most often affected. Across reviewed studies, the authors report that common symptoms include dysmenorrhea, pelvic pain, deep dyspareunia, and intestinal complaints such as diarrhea, tenesmus, hematochezia, and constipation, with complication severity varying by extent of lesions; the rectosigmoid is noted as the most frequently involved region (followed by the appendix, cecum, and small intestine), and constipation and infertility are highlighted as additional significant complications. A major limitation is that the work synthesizes evidence through a review approach rather than presenting new primary data, and it does not provide a quantitative meta-analysis of complication rates. This paper is centrally about endometriosis — specifically deep infiltrating intestinal endometriosis and its major gastrointestinal and reproductive complications.

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Abstract

Introdução: A endometriose infiltrativa profunda (EIP) corresponde a uma das manifestações mais graves da doença, chegando a afetar o intestino em vinte e cinco por cento dos casos. As lesões podem se apresentar como únicas ou multifocais e os sintomas são bem diversificados. Objetivo: O objetivo do presente artigo é demonstrar as principais complicações ocasionadas pela endometriose intestinal infiltrativa profunda. Metodologia: A pesquisa encontra-se fundamentada em uma minuciosa revisão de literatura embasada em artigos minimamente selecionados, levando em consideração os critérios de relevância e atualidade, presentes em bancos de dados científicos. Resultados: Os principais sintomas evidenciados em pacientes com EIP são: dismenorreia, dor pélvica, dispareunia profunda, além de sintomas intestinais, como: diarreia, tenesmo, hematoquezia e constipação. As complicações mais críticas evidenciadas variam de acordo com a extensão da lesão. A região mais frequentemente afetada é o retossigmoide, seguido do apêndice, ceco e intestino delgado. Outras importantes complicações evidenciadas são a constipação intestinal (ocasionada pela progressão lenta das fezes através do cólon e reto) e a infertilidade. Conclusão: Embora complexas e inúmeras sejam as complicações da EIP, algumas técnicas e manejos cirúrgicos podem ser adotados para o controle tanto dos sintomas, quanto das intercorrências, buscando devolver qualidade de vida às pacientes.
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Introduction

Deep infiltrating endometriosis (DIE) is one of the most severe manifestations of the disease, affecting the intestines in twenty-five percent of cases. Lesions can be solitary or multifocal, and symptoms vary widely. Objective: The aim of this article is to demonstrate the main complications caused by deep infiltrating intestinal endometriosis. Methodology: The research is based on a thorough literature review, selecting relevant and up-to-date articles from scientific databases. Results: The main symptoms observed in patients with DIE include dysmenorrhea, pelvic pain, deep dyspareunia, as well as intestinal symptoms such as diarrhea, tenesmus, hematochezia, and constipation. The most critical complications vary according to the extent of the lesions. The most commonly affected region is the rectosigmoid, followed by the appendix, cecum, and small intestine. Other significant complications include intestinal constipation (caused by slow progression of feces through the colon and rectum) and infertility. Conclusion: Although the complications of DIE are complex and numerous, certain surgical techniques and management approaches can be adopted to control both symptoms and complications, aiming to improve the quality of life for patients.

References

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