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FNA cytology with CD 10 immunostain which stain endometrial cells. By courtesy of Dr. Eric Staros. Figure 3. Surgical pathology of the resected colon with endometriosis. By courtesy of Dr. Guihua Cao.
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Endometriosis is the presence of endometrial glands outside the uterine cavity. Endometriosis can involve any part of the bowel but most commonly affects the recto-sigmoid part of the bowel. This case shows the endoscopic views of bowel endometriosis and also elaborates on how to approach and manage similar cases of bowel endometriosis. Patients wi...
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Context 1
... revealed the presence of endometrial glands within the bowel wall. Figure 3 reveals the surgical pathology of the resected colon and shows normal looking colonic mucosa to the right of the slide and endometrial glands within the muscularis pro- pria, surrounded with stroma and active bleeding (red blood cells) within the stroma of the glands. Patient was asympto- matic after resection and she was discharged home. ...
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Citations
... 6 The diagnostic workup is extensive and may require an interdisciplinary evaluation. 8 In this patient with an acute large bowel obstruction, given the non-specific acute symptoms with no relation to the menstrual cycle, it was important to exclude a colonic malignancy because it requires different management and carries a different prognosis. ...
... 10 Thus, it is difficult to make a definitive diagnosis preoperatively because there are no disease-specific radiological or endoscopic findings for lesions with intact intestinal mucosa when biopsies generally yield insufficient tissue for a correct histological diagnosis. 8 Among the imaging options, EUS has been used for more than 20 years to evaluate bowel endometriosis in a reliable and minimally invasive way. 11 Endometriosis lesions usually involve the intestinal wall in an inward manner, starting from the serosa and extending to involve the muscularis propria and submucosa, even though it rarely involves the mucosa. ...
Endometriosis is a relatively common gynecological condition in women of reproductive age. The rectosigmoid region is the most commonly affected segment when the gastrointestinal tract is involved. A differential diagnosis of colorectal neoplasia is difficult because of the similar clinical, endoscopic, and radiology findings. A 42-year-old female presented with abdominal distention and was subsequently diagnosed with a large bowel obstruction in the rectum. A temporary colostomy was performed, and endoscopy revealed a rectal mass obstructing the rectum. The biopsy showed normal mucosa, and it was difficult to exclude rectal malignancies even after the imaging workup. Endoscopic ultrasound demonstrated a hypoechoic lesion below the rectal mucosa, and fine needle aspiration confirmed the diagnosis of bowel endometriosis. Bowel endometriosis is a challenging diagnosis. Endoscopic ultrasound- guided fine-needle aspiration is useful for acquiring adequate samples for histological confirmation and a definitive diagnosis of bowel endometriosis.
... Utilizing the characteristics of strong scattering of ultrasonic waves in liquids containing bubbles, clinical ultrasound contrast agents are injected into human blood vessels to enhance the ultrasound Doppler signal of blood flow and improve the clarity and resolution of ultrasound images. The bubbled liquid has strong ultrasonic scattering characteristics, enhances the background of auxiliary resonance, increases the clarity and resolution of the image, and enhances the ultrasonic diagnostic ability [21,22]. Sensitive and specific ultrasound contrast agents are also called amplifiers. ...
In order to compare the microscopic ultrastructure of eutopic endometrium and normal endometrium in patients with endometriosis, to study the specific pathogenesis of endometriosis. In this paper, on the basis of using B-ultrasound technology, several patients with endometriosis were subjected to B-ultrasound to observe the ultrastructure of the eutopic uterine endometrium and compared with the pictures of normal endometrium to carry out the specific analysis between the two ultrastructural comparisons. This study is based on the analysis of B-ultrasound images of patients with endometriosis, compares the difference between their ultrastructure and normal human body, and conducts specific pathological diagnosis and analysis to find out the impact of the endometrium in place. The specific factors of the occurrence of lesions and the corresponding treatment methods are proposed. The experimental results show that the ultrastructure of endometriosis eutopic endometrium is different from that of normal endometrium. The microvilli of secretory cells and the cilia of ciliated cells of the former are abnormally increased and lengthened, and they are superior to B-ultrasound technology. The success rate of the examination is 93.75%, which can play an important role in the specific examination process of patients with endometriosis, as one of the actual indicators of detection. Under the electron microscope, microvilli are tiny finger-like protrusions extending from the cell membrane and the cytoplasm on the free surface of the cell, surrounded by the cell membrane and perpendicular to the cell membrane surface.
... Вовлечение в патологический процесс колоректального отдела кишечника приводит к изменениям функции кишечника, и может проявляться такими симптомами как запор, диарея, тенезмы и редко ректальное кровотечение [3]. Помимо этого пациенты обычно жалуются на наличие множества других симптомов, таких как абдоминальная и тазовая боль, дисхезия, дисменорея, циклическое ректальное кровотечение, диспареуния и бесплодие [4, 14,15]. Дифференциальная диагностика при эндометриозе колоректального отдела кишечника должна быть проведена с синдромом раздраженного кишечника, ульцерозным колитом, синдромом солитарной язвы прямой кишки и опухолью прямой кишки [3]. ...
... Так, по данным авторов, при сравнении результатов колоноскопии с результатами лапароскопии и гистологии было установлено, что чувствительность, специфичность, положительные и отрицательные прогностические значения колоноскопии для диагностики кишечного эндометриоза составили 7 %, 98 %, 85 % и 58 %, соответственно [23]. В то же время, колоноскопическое исследование с одновременной биопсией может быть полезно в некоторых случаях эндометриоза кишечника с поражением слизистой и/или подслизистой оболочки [15]. ...
Endometriosis is a prevalent disease in females of the childbearing age. It may be accompanied by bowel involvement. In such cases, the most frequently observed lesion locations are the rectum and the rectosigmoid with the occurrence rate of 3-37 %. Treatment of severe forms of deep infiltrating endometriosis with bowel wall involvement is one of the most challenging problems of modern gynaecology. Apart from general intra- and postoperative risks (haemorrhage, infection, direct damage to the organs) or bowel and bladder dysfunction, one of the most severe complications is the development of anastomotic leaks. This article presents a review of literatures dated 2010-2020 searched for in PubMed and Google Scholar databases and devoted to operative treatment of patients with deep infi ltrating endometriosis. We made an emphasis on the effi cacy of the multidisciplinary approach to operative treatment of patients with deep infiltrating endometriosis and bowel involvement. Multidisciplinary laparoscopic treatment has become a standard of medical aid in deep infiltrating endometriosis. Depending on the size of endometrial lesion and the location of bowel involvement, complete removal of the infiltrate or bowel resection is performed in cooperation with an experienced colorectal surgeon. The operative tactics in laparoscopic endometriosis resection, including bowel resection, may provide advantages for both the patients and the healthcare system. The optimal model is to be chosen drawing on the basis of the maximum benefit for the patient.
