Endométriose

G Roseau
In: Écho-endoscopie digestive · 2012 · pp. 313–318 · doi:10.1007/978-2-287-99164-6_39 · W4232665427
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Endometriosis affects 5-10% of reproductive-aged women and deep pelvic endometriosis, often involving the rectum and sigmoid, infiltrates the digestive wall from outside-in.

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This 2012 French chapter describes endometriosis as an ectopic proliferation of functional endometrium affecting about 5–10% of women of reproductive age, with emphasis on deep pelvic endometriosis. It outlines how imaging modalities such as ultrasound, MRI, and endoscopic ultrasound help diagnosis, and maps typical sites of deep infiltration—including ovaries, uterosacral ligaments, the torus, and primarily the rectum and distal sigmoid within the digestive tract. The chapter explains that digestive lesions originate from specific pelvic structures (rectouterine septum or uterosacral ligaments), then spread through layers by penetrating the serosa and infiltrating muscle from outside in, with submucosal involvement possible though “transfixing” involvement is rare. This paper is centrally about endometriosis — it focuses on the definition, typical deep pelvic anatomic spread, and imaging context for diagnosing deep infiltrating endometriosis.

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Résumé Prolifération ectopique d’endomètre fonctionnel, l’endométriose (EM) concerne 5 à 10 % des femmes en age de procréer. L’EM pelvienne profonde, dont le diagnostic est facilité par l’imagerie (échographie, IRM, EER), est habituellement développée en souspéritonéal. Elle concerne les ovaires, les ligaments utéro-sacrés, le torus et, au plan digestif, principalement le rectum et le sigmoïde distal. Ces atteintes digestives se développent respectivement à partir de nodules de la cloison rectoutérine ou des ligaments utéro-sacrés. Après avoir traversé la séreuse, elles infiltrent la musculeuse de dehors en dedans en commençant par la musculeuse longitudinale externe. Si les atteintes « traversantes » sont rares, l’atteinte de la sousmuqueuse est possible ; elle s’intègre habituellement dans une infiltration digestive d’au moins 40 % de la circonférence. Preview Unable to display preview. Download preview PDF. Bibliographie Bazot M, Malzy P, Cortez A et al. (2007) Accuracy of transvaginal sonography and rectal endoscopic sonography in the diagnosis of deep infiltrating endometriosis. Ultrasound Obstet Gynecol 30: 994–1001 Dumontier Isabelle (2008) Endometriosis In: Godeberge Ph, ed. Anorectal diseases Textbook. Paris: Médecine Science Flammarion Griffiths A, Koutsouridou R, Vaughan S et al. (2008) Transrectal ultrasound and the diagnosis of rectovaginal endometriosis: a prospective observational. Study Acta Obstet Gynecol Scand 87: 445–448 Piketty M, Chopin N, Dousset B et al. (2009) Preoperative work-up for patients with deeply infiltrating endometriosis: transvaginal ultrasonography must definitely be the first-line imaging examination. Hum Reprod 24: 602–607 Rights and permissions Copyright information © 2012 Springer-Verlag France About this chapter Cite this chapter Roseau, G. (2012). Endométriose. In: Écho-endoscopie digestive. Springer, Paris. https://doi.org/10.1007/978-2-287-99164-6_39 Download citation DOI: https://doi.org/10.1007/978-2-287-99164-6_39 Publisher Name: Springer, Paris Print ISBN: 978-2-287-99163-9 Online ISBN: 978-2-287-99164-6 eBook Packages: MedicineMedicine (R0)

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