Barium Enema Evaluation of Colonic Involvement in Endometriosis

Niccolò Faccioli, Riccardo Manfredi, Paride Mainardi, Emiliano Dalla Chiara, Elide Spoto, Luca Minelli, Roberto Pozzi Mucelli
AJR. American journal of roentgenology · 2008 · vol. 190(4) , pp. 1050–1054 · doi:10.2214/ajr.07.3062 · PMID:18356454 · W2036859596
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Double-contrast barium enema accurately identified bowel endometriosis lesions, correlating well with surgical pathology, and aiding in surgical planning for affected patients.

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Abstract

OBJECTIVE: The purpose of our study was to define the role of double-contrast barium enema (DCBE) compared with laparoscopy in the diagnosis and local staging of intestinal endometriosis. MATERIALS AND METHODS: A search of our radiology database revealed the cases of 234 women who underwent surgical resection for pelvic endometriosis with associated intestinal surgery for intestinal endometriosis. We retrospectively evaluated all preoperative DCBE images for the presence of bowel endometriosis and the number, site (rectum, sigmoid, cecum), and size of the lesions. The radiographic findings at DCBE were retrospectively correlated with those at surgical pathologic examination. RESULTS: DCBE revealed 211 intestinal lesions of bowel endometriosis in 168 (71.8%) of 234 patients with pelvic endometriosis clinically enrolled. Forty (23.8%) of the 168 women had more than one endometriotic bowel nodule (two nodules in 37 cases, three in three cases). Laparoscopy revealed 233 intestinal lesions in 174 (74.3%) of the patients. Fifty-four (31.0%) of 174 women had more than one endometriotic bowel nodule (two nodules in 49 cases, three in five cases). There was 100% correlation between the DCBE and histologic findings as far as site and size of the lesions were concerned. DCBE had a sensitivity of 88.4%, specificity of 93.0%, positive predictive value of 97.5%, negative predictive of 71.0%, and accuracy of 89.5% in the identification of bowel endometriosis. CONCLUSION: DCBE is helpful in discerning bowel wall involvement in endometriosis, enabling proper surgical planning. DCBE also appears to have a role in the management of endometriosis.

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Barium Sulfate Colonic Diseases Endometriosis Enema Adult Colonic Diseases Colonic Diseases Contrast Media Endometriosis Endometriosis Enema Female Humans Laparoscopy Radiography Retrospective Studies

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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Cited by (48)

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