MRI facilitated a diagnosis of endometriosis of the rectum

Eguchi S, Susumu Eguchi, S Eguchi, Koh Komuta, K Komuta, Komuta K, Masashi Haraguchi, M Haraguchi, Haraguchi M, Furui J, Junichiro Furui, J Furui, Kanematsu T, T Kanematsu, Takashi Kanematsu
Journal of gastroenterology · 2000 · vol. 35(10) , pp. 784–788 · doi:10.1007/s005350070039 · PMID:11063224 · W2010403816
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MRI revealed a cystic lesion in the rectal wall, leading to a diagnosis of bowel endometriosis via biopsy in a patient with chronic abdominal pain.

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This case report describes a 51-year-old pre-menopausal Japanese woman with chronic lower abdominal pain who had a stenotic recto-sigmoid lesion on barium enema and a thickened rectal wall on pelvic CT, with colonoscopy showing constriction but intact mucosa. MRI demonstrated T1 high-intensity cystic lesions within the thickened rectal wall, leading the authors to suspect rectal/bowel endometriosis; histology from biopsy identified endometrial epithelium within the interstitial layer of histologically normal mucosa, and the final diagnosis was endometriosis of the rectum. The patient became asymptomatic after hormonal treatment and later entered spontaneous menopause, and the authors note MRI’s usefulness for diagnosis while avoiding unnecessary laparotomy. This paper is centrally about endometriosis — it reports an MRI- and biopsy-based diagnosis of rectal endometriosis.

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Abstract

A 51-year-old pre-menopausal Japanese woman suffering from chronic lower abdominal pain was referred to our hospital. A barium enema showed a stenotic lesion in the recto-sigmoid region, and a pelvic computed axial tomography (CAT) scan revealed a thickened rectal wall. A colonoscopic examination showed the rectum to be constrictive, but the mucosa appeared to be intact. Magnetic resonance imaging (MRI) with T1 high-intensity revealed a cystic lesion in the thickened wall of the rectum, which led us to suspect possible bowel endometriosis. Part of the biopsy specimen showed endometrial epithelium within the interstitial layer of histologically normal mucosa; finally, endometriosis of the rectum was diagnosed. The patient became asymptomatic after the initiation of hormonal treatment and later experienced spontaneous menopause. MRI was effective for diagnosis and the patient did not undergo unnecessary laparotomy. Although bowel endometriosis is generally diagnosed by means of resected specimens, in our patient, diagnosis was made using MRI and biopsy, and hormonal therapy had an effective role as a bridge to menopause.
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Abstract: A 51-year-old pre-menopausal Japanese woman suffering from chronic lower abdominal pain was referred to our hospital. A barium enema showed a stenotic lesion in the recto-sigmoid region, and a pelvic computed axial tomography (CAT) scan revealed a thickened rectal wall. A colonoscopic examination showed the rectum to be constrictive, but the mucosa appeared to be intact. Magnetic resonance imaging (MRI) with T1 high-intensity revealed a cystic lesion in the thickened wall of the rectum, which led us to suspect possible bowel endometriosis. Part of the biopsy specimen showed endometrial epithelium within the interstitial layer of histologically normal mucosa; finally, endometriosis of the rectum was diagnosed. The patient became asymptomatic after the initiation of hormonal treatment and later experienced spontaneous menopause. MRI was effective for diagnosis and the patient did not undergo unnecessary laparotomy. Although bowel endometriosis is generally diagnosed by means of resected specimens, in our patient, diagnosis was made using MRI and biopsy, and hormonal therapy had an effective role as a bridge to menopause. Similar content being viewed by others Author information Authors and Affiliations Additional information Received: July 12, 1999 / Accepted: January 28, 2000 Rights and permissions About this article Cite this article Eguchi, S., Komuta, K., Haraguchi, M. et al. MRI facilitated a diagnosis of endometriosis of the rectum. J Gastroenterol 35, 784–788 (2000). https://doi.org/10.1007/s005350070039 Issue date: DOI: https://doi.org/10.1007/s005350070039

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Magnetic Resonance Imaging Rectal Neoplasms Biopsy Endometriosis Female Humans Middle Aged Rectal Neoplasms Tomography, X-Ray Computed

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