A Multidisciplinary Approach to the Patient with Deep Infiltrating Endometriosis

Amanda Ulrich, Moona Arabkhazaeli, Gary Dellacerra, Flavio Malcher, Veronica Lerner
In: Obstetrics and Gynaecology Cases - Reviews · 2021 · vol. 8(2) · doi:10.23937/2377-9004/1410196 · W3154725526
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This paper highlights the importance of multidisciplinary preoperative planning, including specialized MRI with contrast, and referral to subspecialists for optimizing surgical outcomes in patients with deep infiltrating endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This case series/review article describes three patients with deep infiltrating endometriosis (DIE), focusing on how preoperative suspicion, specialized MRI (including DIE protocols with vaginal/rectal contrast), and multidisciplinary surgical planning affected operative planning and completeness of resection. Across the cases, imaging and specialist referrals helped identify or re-contextualize disease sites such as rectovaginal/rectosigmoid lesions and concurrent adenomyosis, whereas one case highlights a limitation of prior incomplete preoperative anticipation of bowel involvement leading to lack of colorectal surgical backup. The authors also note that while transvaginal ultrasound sensitivity can be high in expert hands, it is operator dependent, and they cite evidence that MRI can better detect uterosacral and vaginal involvement compared with rectal endoscopic sonography. This paper is centrally about endometriosis — it specifically addresses multidisciplinary preoperative diagnosis and imaging strategy for deep infiltrating endometriosis.

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Abstract

Endometriosis is a prevalent condition that affects women's health-related quality of life worldwide and deep infiltrating endometriosis represents a subset of these patients who are most severely affected. Due to the complex nature of deep infiltrating endometriosis (DIE) a preoperative suspicion for the condition allows for coordination of a multidisciplinary approach to surgical planning, a key to successful surgical resection. We describe three patient cases to highlight the importance of preoperative planning and the added benefit of imaging with an MRI protocol specific for DIE that includes vaginal and rectal contrast. Additionally, we emphasize the importance of appropriate referral to surgical subspecialists to allow for coordination of care during pre-operative planning to improve outcomes of patients with deep infiltrating endometriosis.

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Condition tags

endometriosisdie_deep_infiltrating

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.

References (13)

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