OP11.05: ‘Muscle thickness’ symptom in case of external genital endometriosis

To investigate specific features of the intestine involvement in external genital endometriosis pathologic process. Transvaginal echographic prospective study of 28 women with external genital endometriosis was produced. Average age was 36.7 years (from 23 up to 46 years). We observed 6 cases with endometrioid retrocervical infiltrates (4 among them—with intestine involvement); 20—with endometriomas: 9 one- and 11 double-sided (6 observations among them with endometrioid intestine process) and 2 cases with endometrioid heterotopias (2 intestine involvement). All women were underwent a laparoscopic operation including laser-vaporization and electrocoagulation of endometriosis focus and infiltration. The monthly injections of lukrine-depo treatment were carried out during 3–6 months postoperational period. Intestine endometrioid pathologic process was revealed in total of 12 (42.9%) women of investigated group. True-positive echografic preoperative diagnose was made in 10 cases. Two cases of false-negative diagnosis occurred due to large double-sided endometriomas (from 7.5 up to 13.5 cm). Ultrasound examination of rectal or sigmoid colon with external endometriois process revealed the local intestine muscle bulge in endometrioid invasion zone (6–17 mm). This specific sign was clearly visualized and revealed not only in case of endometrioid infiltration but also in endometrioid heterotopias. Infiltrate presence was identified as a hyperechoic area near external contour of the muscle bulge. During further observation under lukrine-depo treatment the decrease and consolidation were noticed only in infiltration hyperechoic part, the muscle sickness though remained without changes. The involved intestine muscle thickening should be regarded as compensatory reaction for mucous membrane and intestine lumen isolation from pathologic process. The ultrasound examination makes visualization possible even in endometrioid heterotopias.