Moose Antler Sign, a Sign of Deep Endometriosis Infiltrating Bowel

Zazzera, Vincent Della; Benning, Harbinder; Lortie, Karine; Singh, Sukhbir S.

doi:10.1016/j.jmig.2016.09.011

Cited by 5 publications

(3 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In DE, the presence of soft-tissue nodules and plaques together with fibrosis leads to reduced mobility of the pelvic organs, resulting in absence of the 'sliding sign' of the anterior or posterior compartment in case of obliteration of the vesicouterine pouch or the pouch of Douglas, respectively 11,[56][57][58] . When the rectal wall is involved, a mass with band-like extensions may be seen, resembling a 'moose antler' 59 (formerly also described as an 'Indian head-dress' 60 ) which suggests invasion of the mucosa or submucosa (Figure 1). Endometriomas typically present as ovarian cysts with ground-glass echogenicity, and one to four compartments without papillary structures 61 .…”

Section: Transvaginal Ultrasonographymentioning

confidence: 99%

IDEAL study: magnetic resonance imaging for suspected deep endometriosis assessment prior to laparoscopy is as reliable as radiological imaging as a complement to transvaginal ultrasonography

Bielen

Tomassetti

Schoubroeck

et al. 2020

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

Objective To compare the value of using one‐stop magnetic resonance imaging (MRI) vs standard radiological imaging as a supplement to transvaginal ultrasonography (TVS) for the preoperative assessment of patients with endometriosis referred for surgery in a tertiary care academic center. Methods This prospective observational study compared the diagnostic value of the standard preoperative imaging practice of our center, which involves expert TVS complemented by intravenous urography (IVU) for the evaluation of the ureters and double‐contrast barium enema (DCBE) for the evaluation of the rectum, sigmoid and cecum, with that of expert TVS complemented by a ‘one‐stop’ MRI examination evaluating the upper abdomen, pelvis, kidneys and ureters as well as rectum and sigmoid on the same day, for the preoperative triaging of 74 women with clinically suspected deep endometriosis. The findings at laparoscopy were considered the reference standard. Patients were stratified according to their need for monodisciplinary surgical approach, carried out by gynecologists only, or multidisciplinary surgical approach, involving abdominal surgeons and/or urologists, based on the extent to which endometriosis affected the reproductive organs, bowel, ureters, bladder or other abdominal organs. Results Our standard preoperative imaging approach and the combined findings of TVS and MRI had similar diagnostic performance, resulting in correct stratification for a monodisciplinary or a multidisciplinary surgical approach of 67/74 (90.5%) patients. However, there were differences between the estimation of the severity of disease by DCBE and MRI. The severity of rectal involvement was underestimated in 2.7% of the patients by both TVS and DCBE, whereas it was overestimated in 6.8% of the patients by TVS and/or DCBE. Conclusions Complementary to expert TVS, ‘one‐stop’ MRI can predict intraoperative findings equally well as standard radiological imaging (IVU and DCBE) in patients referred for endometriosis surgery in a tertiary care academic center. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

show abstract

Section: Transvaginal Ultrasonographymentioning

confidence: 99%

IDEAL study: magnetic resonance imaging for suspected deep endometriosis assessment prior to laparoscopy is as reliable as radiological imaging as a complement to transvaginal ultrasonography

Bielen

Tomassetti

Schoubroeck

et al. 2020

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

show abstract

“…Expert guided transvaginal ultrasound 2 revealed a hypoechoic, avascular, deep lesion along the rectal muscularis layer measuring 3.7 cm x 1.2 cm x 2.4 cm (Figure 1). The nodule also demonstrated signs of bowel retraction and tethering to the back of the uterus 3 .…”

Section: Manuscriptmentioning

confidence: 98%

Targeted Ultrasound for Deep Bowel Endometriosis

Kan

Zazzera

Williams

et al. 2022

Journal of Minimally Invasive Gynecology

Self Cite

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

“…MRI or TRUS can suggest an obliterated posterior cul-de-sac. 17 Similarly if extrapelvic endometriosis is suspected, appropriate preoperative evaluation involving organ system should be performed.…”

Section: Diagnosis Of Endometriosismentioning

confidence: 99%

Endometriosis and Female Pelvic Pain

Kim

Han

2018

Semin Reprod Med

View full text Add to dashboard Cite

Endometriosis is a nonmalignant gynecologic disorder that can have a significant impact on a woman's quality of life with pelvic pain and possible lasting effects on one's fertility. Symptoms, when present, can be severe and affect many organ systems including the gastrointestinal and urinary systems. Other etiologies of pelvic pain must be ruled out and/or need to be addressed concurrently for optimal patient care. There are numerous medical and surgical treatment options available that have been shown to be beneficial for endometriosis-related pelvic pain. Recurrence is common when medications are discontinued and even after surgical therapy. Ultimately, the treatment approach will be dependent on the needs of the patient, taking into consideration the patient's desire for fertility, symptoms, past treatment, and patient preferences.

show abstract

Moose Antler Sign, a Sign of Deep Endometriosis Infiltrating Bowel

Cited by 5 publications

References 3 publications

IDEAL study: magnetic resonance imaging for suspected deep endometriosis assessment prior to laparoscopy is as reliable as radiological imaging as a complement to transvaginal ultrasonography

IDEAL study: magnetic resonance imaging for suspected deep endometriosis assessment prior to laparoscopy is as reliable as radiological imaging as a complement to transvaginal ultrasonography

Targeted Ultrasound for Deep Bowel Endometriosis

Endometriosis and Female Pelvic Pain

Contact Info

Product

Resources

About