Endoluminal ultrasound diagnosis and operative management of rectal endometriosis

Jörg Schröder, J Schröder, M Löhnert, J M Doniec, Julius Marek Doniec, P Dohrmann
Diseases of the colon and rectum · 1997 · vol. 40(5) , pp. 614–617 · doi:10.1007/bf02055389 · PMID:9152194 · W1973747731
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Endorectal ultrasound accurately diagnosed rectal wall involvement by endometriosis in patients, guiding operative management toward laparotomy and bowel resection when involvement was present.

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Abstract

PURPOSE: Endorectal ultrasound was performed in patients with endometriosis to evaluate the role of this technique for rectal wall involvement and to evaluate the position of preoperative diagnosis in the operative management of rectal endometriosis. METHODS: Sixteen patients with suspected fixation of endometriomas to the rectal wall during bimanual examination were included in the study. Endorectal ultrasound was performed using a real time unit with a 7.5 MHz endorectal transducer. The probe was introduced via a rectoscope into the rectum up to the rectosigmoid. RESULTS: Endometriosis was confirmed histopathologically in all patients. In six patients rectal wall involvement was diagnosed, in two patients endometriomas were adjacent to the rectal wall, and in eight patients rectal wall involvement could be excluded. Preoperative diagnosis was confirmed in all patients during operation. Laparotomy was performed in those patients with preoperatively diagnosed rectal wall involvement, whereas the remaining patients were treated laparoscopically. Endometriomas with rectal wall involvement were treated in five of six patients with resection of the affected bowel predominantly by low anterior resection. CONCLUSIONS: Preoperative endorectal ultrasound is a reliable technique to visualize perirectal endometriomas and to assess rectal wall involvement. Based on preoperative endosonographic diagnosis, an operative management was established with laparotomy and resection of the affected bowel in cases of rectal wall involvement.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Endosonography Rectal Diseases Adult Endometriosis Endometriosis Endometriosis Female Humans Middle Aged Prospective Studies Rectal Diseases Rectal Diseases Rectal Diseases

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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