Presentation of endometriosis to general surgeons: A 10-year experience

Singh, K.; Lessells, A M; Adam, D. J.; Jordan, Catherine O.; Miles, W. F. A.; Macintyre, I. M. C.; Greig, J. D.

doi:10.1002/bjs.1800821017

Cited by 175 publications

(148 citation statements)

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“…RECTO-SIGMOID ENDOMETRIOSIS is a severe form of deeply infiltrating endometriosis (DIE) and accounts for more than 70% of cases of intestinal endometriosis (1,2). Recto-sigmoid endometriosis may produce nonspecific symptoms such as diarrhea, rectal bleeding, and abdominal colic-like pain.…”

mentioning

confidence: 99%

MRI and “Tenderness Guided” transvaginal ultrasonography in the diagnosis of recto‐sigmoid endometriosis

Saba

Guerriero

Sulcis

et al. 2011

Magnetic Resonance Imaging

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Purpose: To compare the diagnostic accuracy of MRI and ''tenderness-guided'' transvaginal ultrasonography (tg-TVUS) in the identification of recto-sigmoid endometriosis. Materials and Methods:Institutional Review Board approval for this study was obtained, and written informed consent was given by all patients. This study is compliant with the STARD (Standards for Reporting of Diagnostic Accuracy) method. Fifty-nine patients (mean age, 33 years; range, 21-44 years) with clinical suspicion of deep pelvic endometriosis were prospectively enrolled. They underwent tg-TVUS and MRI before surgery. The characteristics of the MRI signal were analyzed. Mapping of recto-sigmoid endometriosis was performed and tg-TVUS and MR imaging results were compared with surgical and pathological findings. Sensitivity, specificity, and the positive and negative likelihood ratio (LRþ and LRÀ) were calculated. Inter-technique concordance was assessed using the Cohen statistic, and receiver operating characteristic (ROC) curves were obtained. Logistic regression analysis was performed.Results: The prevalence of recto-sigmoid endometriosis was 51%. The specificity, sensitivity, and LRþ and LRÀ were 90%, 73%, 7.089 and 0.297, respectively, for MRI and 86%, 73%, 5.317 and 0.309, respectively, for tg-TVUS. The presence of a high T1 signal spot was an excellent specific finding (100%) but was associated with a low sensitivity (30%). Inter-technique concordance using the Cohen statistic indicated a kappa value of 0.658 (6 0.098 SD). According to the logistic regression equation obtained, the use of both tg-TVUS and MRI allows optimal diagnostic performance.Conclusion: MRI and tg-TVUS show similar results in the identification of recto-sigmoid endometriosis. The Cohen kappa value suggests that these methods may have complementary roles in the identification of recto-sigmoid endometriosis, depending on the site affected.

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confidence: 99%

MRI and “Tenderness Guided” transvaginal ultrasonography in the diagnosis of recto‐sigmoid endometriosis

Saba

Guerriero

Sulcis

et al. 2011

Magnetic Resonance Imaging

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“…Existen reportes de estenosis ileal secundaria a endometriosis, que condiciona obstrucciones más bien crónicas; sin embargo, la presentación más frecuente es una obstrucción solitaria en íleon terminal, que debe ser resecada (16) . La …”

Section: Caso Radiologico Para Diagnostico Resultado Caso Clinico Radunclassified

Dolor Colico Y Distension Abdominal

Avaria¹,

O'Brien

2008

Rev. chil. radiol.

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“…Therefore, excision should be large 2,3,7,8,11 , to remove all the segments of skin, subcutaneous tissue, muscle, aponeurosis and peritoneum potentially involved (Figure 2). If possible, the defect created by excision borders must be corrected with his own abdominal muscles and aponeurosis.…”

Section: Discussionmentioning

confidence: 99%

Endometrioma de parede abdominal

Accetta¹,

Accetta²,

Accetta³

et al. 2011

ABCD, arq. bras. cir. dig.

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headings -Endometriosis. Abdominal wall.abstRact -Background: The exact incidence of endometriosis in the general population is unknown. Confirmation of this disease is only possible by histopathological analysis of a fragment obtained by some invasive procedure, because there is so far, no clinical secure marker. Aim: To report the experience with the clinical manifestations and surgical treatment in patients with abdominal wall endometrioma. Methods: Retrospective analysis of patients operated for abdominal wall endometrioma with emphasis on data relating to age, symptoms, previous cesarean, relation of symptoms with the menstrual cycle, physical examinations and additional surgical treatment, postoperative course and histopathological results of specimens. Results: Forteen patients were operated during the study period, aged between 28 and 40 years. The presence of local mass and pain that worsened during menstruation were the main complaints. Ultrasound and CT examinations were important to precisely localize the disease. Surgical excision was a wide excision of the tumor and affected tissues. The patient progressed satisfactorily and histopathology confirmed the diagnosis of abdominal wall endometrioma in all cases. Conclusion: Exists a clear relationship between cesarean operation and abdominal wall endometrioma; ultrasound studies and CT scans help to plan the surgical resection allowing resection of tumor and all affected adjacent tissues. Resumo -Racional:A incidência exata da endometriose na população geral é desconhecida. A confirmação desta doença só é possível através da análise histopatológica de um fragmento obtido por algum procedimento invasivo, pois não existe até o momento, nenhum marcador clínico seguro. Objetivo: Relatar a experiência com as manifestações clínicas e o tratamento cirúrgico em pacientes com endometrioma de parede abdominal. Método: Análise retrospectiva das pacientes operadas por endometrioma de parede abdominal, dando ênfase aos dados relativos à idade, sintomas, cesariana prévia, relação dos sintomas com o ciclo menstrual, exames físicos e complementares, tratamento cirúrgico, evolução pós-operatória e resultado histopatológico dos espécimes. Resultados: Foram operadas 14 pacientes no período estudado, com idade entre 28 e 40 anos. A presença de massa e dor local que piorava durante a menstruação foram as queixas principais. Ultrassonografia e tomografia computadorizada foram exames importantes em localizar precisamente a doença. O tratamento cirúrgico foi exérese ampla da tumoração e dos tecidos comprometidos. As pacientes evoluíram satisfatoriamente e o histopatológico confirmou a suspeita de endometrioma de parede abdominal em todos os casos. Conclusão: Foi nítida a relação entre cesariana prévia e endometrioma de parede abdominal e estudos ultrassonográficos e tomográficos auxiliaram a planejar a abordagem cirúrgica permitindo a exérese da tumoração e de todos os tecidos adjacentes comprometidos.correspondência:

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Presentation of endometriosis to general surgeons: A 10-year experience

Cited by 175 publications

References 5 publications

MRI and “Tenderness Guided” transvaginal ultrasonography in the diagnosis of recto‐sigmoid endometriosis

MRI and “Tenderness Guided” transvaginal ultrasonography in the diagnosis of recto‐sigmoid endometriosis

Dolor Colico Y Distension Abdominal

Endometrioma de parede abdominal

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