P08.05: Sigmoid endometriosis: sonographic‐based conservative management by LNG‐IUS

A 38-year-old woman presented with cyclic worsening dysmenorrhea, deep dyspareunia and dyschezia during last year. Transvaginal sonography (TVS) showed normal uterus and ovaries for morphology, mobility, site, size and tenderness. On the left, an inhomogeneous hypoechoic lesion which modified sigma, painful at push-and-pull manoeuvres was observed, highly suspicious for sigmoid endometriosis. Enema confirmed the TVS image. By the imaging diagnosis of endometriosis, a LNG-IUS was placed. At nine months follow-up, the patients referred dramatically improvement of symptoms with pain only evoked by gynaecological visit. Accurate diagnosis by TVS of sigmoid endometriosis may permit a conservative medical treatment based on LNG-IUS avoiding complex surgery.