Prospektív vizsgálat a sigmoideoscopia diagnosztikai érzékenységének meghatározására vastagbelet infiltráló endometriosisban

Péter Lukovich, Noémi Csibi, Réka Brubel, Krisztina Tari, Szilvia Csuka, László Harsányi, János Rigó, Attila Bokor
Orvosi hetilap · 2017 · vol. 158(7) , pp. 264–269 · doi:10.1556/650.2017.30663 · PMID:28462623 · W2588074329
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Sigmoidoscopy demonstrated 96.2% sensitivity and 92.8% specificity for diagnosing bowel endometriosis, with secondary signs aiding detection when mucosal invasion was absent.

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Abstract

INTRODUCTION AND AIM: In the treatment of colorectal endometriosis a multidisciplinary laparoscopic resection is suggested, for this reason the correct selection of bowel infiltration is essential before surgery. PATIENTS AND METHOD: Between 2009 and 2015, 383 sigmoidoscopies were performed in patients with endometriosis. Where mucosal invasion was absent secondary signs (wall rigidity, impression, kinking, pain during the examination, suffusion) were analysed. In endoscopically confirmed cases multidisciplinary surgery was performed, the remaining patients were operated by a gynecologic team only. RESULTS: Endometriosis was endoscopically confirmed in 224 patients (58.49%), 108 of them underwent multidisciplinary operation, the negative 135 cases received gynaecological surgery. Bowel endometriosis was confirmed in 103 out of 108 cases intraoperatively, while in 8 cases of the sigmoidoscopically negative patients bowel infiltration was diagnosed intraoperatively by the gynaecological team. Complete sigmoidoscopy was performed in 43.47% of the cases. Intraluminal endometriosis was found in 4.91%, secondary signs as rigidity in 38.39%, impression in 45.54%, kinking in 57.14%, pain (in cases of examination without narcosis) in 26.06% and suffusion in 3.82% of the cases was found during sigmoidoscopy. Sigmoidoscopic examination has a 92.8% specificity and 96.2% sensitivity in cases of bowel endometriosis. CONCLUSION: Sigmoidoscopy performed by an experienced gastroenterologist is a highly sensitive examination for the diagnosis of bowel endometriosis. Orv. Hetil., 2017, 158(7), 264-269.

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Endometriosis Rectal Diseases Sigmoidoscopy Adult Endometriosis Endometriosis Endometriosis Endosonography Endosonography Female Humans Middle Aged Prospective Studies Rectal Diseases Rectal Diseases Rectal Diseases Sigmoidoscopy

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