[Bowel endometriosis. Eight cases of colorectal resection].
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This report describes eight cases of colorectal endometriosis requiring resection, highlighting diagnostic challenges and recommending full excision or bowel resection based on infiltration depth.
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Abstract
Colo-rectal endometriosis requiring colon resection are reported in 8 patients to illustrated the diagnostic and therapeutic problems encountered in the management of this uncommon localisation. Pericatamenial or catamenial bowel symptoms associated with pelvic genital involvement were encountered in all cases. Clinical examination, barium enema and colonoscopy are essential to guide surgical management looking for multiple localisations. However their diagnostic value is low as endometriosis rarely involves the mucosa. Endosonography appears to be very promising in evaluating the depth of infiltration of the bowel. The treatment of bowel endometriosis is controversial and varies greatly according to the patient's complaints and clinical data. The indications and limits of all treatment modalities including abstention, medical, and surgical treatment are discussed. From the cases reported we conclude that symptomatic bowel endometriosis should be fully excised whenever possible, and the surgical procedure should be adapted to the depth of infiltration. A full thickness excision or bowel resection is mandatory in patients with deep muscularis involvement. These procedures, which are often difficult due to extensive fibrosis and adhesions, may be achieved by laparoscopy in selected patients.
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Cited by (16)
- Y a-t-il une place pour la cœlioscopie dans le parcours en assistance médicale à la procréation ? 2015
- Delivery and pregnancy outcome in women with bowel resection for deep endometriosis: a retrospective cohort study 2015
- Transrectal ultrasound – Techniques and outcomes in the management of intestinal endometriosis 2012
- Traitement chirurgical de l'endométriose des ligaments utérosacrés et du cul-de-sac postérieur 2009
- Laparoscopic treatment of bowel endometriosis in infertile women 2009
- Laparoscopic resection of intestinal endometriosis: A 5-year experience 2006
- Traitement cœlioscopique de l'endométriose profonde. À propos de 118 cas 2006
- Fertility after laparoscopic colorectal resection for endometriosis: preliminary results 2005
- Prise en charge chirurgicale des endométrioses de la cloison rectovaginale. À propos d’une série continue de 50 cas 2004
- L’endométriose pelvienne profonde : prise en charge thérapeutique et proposition d’une « classification chirurgicale » 2003
- Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification 2003
- Endométriose profonde : plaidoyer pour l’écoute des patientes et pour le toucher vaginal ! 2003
- Prise en charge chirurgicale des nodules endométriosiques de la cloison recto-vaginale. A propos d'une série continue de 40 cas 2002
- Endométriose colorectale. Diagnostic et prise en charge 2001
- 10.1016/s2211-0666(21)67259-6 2000
- Disseminação linfática na endometriose colorretal 2000
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