Chapters authored
Endoscopic Ultrasound and Intestinal Endometriosis
Endometriosis is a benign gynecological disease characterized by histological confirmation of the presence of ectopic endometrial glands and/or endometrial stroma. The main clinical gynecologic manifestations include chronic pelvic pain, back pain, menstrual disorders, and infertility. Over 60% of women with endometriosis have chronic intestinal symptoms. Intestinal involvement occurs in up to 12% of patients. Intestinal deep infiltrating endometriosis is defined as the lesion infiltrating at least the muscular layer of the bowel wall. Gynecological pelvic exam is not sufficient for the diagnosis of the location of deeply infiltrating endometriosis. Imaging methods can suggest the diagnosis of endometriosis and help to map the disease. Transrectal ultrasound (TRUS) has been used for more than a decade for the diagnosis and staging of deep endometriosis, providing relevant data for surgical treatment. It is useful to determine the depth of infiltration and the distance from the anal junction. The recent trend is to prefer nodule excision, when feasible, rather than radical digestive resection; therefore, it is important to take into consideration the staging of rectal and sigmoid infiltrating endometriosis in the preoperative clinical evaluation.
Part of the book: Endoscopic Ultrasound