title: Preoperative double-contrast barium enema in patients with suspected intestinal endometriosis.
abstract: OBJECTIVE
  To assess the usefulness of double-contrast barium enema (DCBE) in the diagnosis of endometriotic lesions of the bowel and to define its potential value in preoperative decision making for intestinal surgery.
  
  
  METHODS
  Retrospective study (Canadian Task Force classification II-2).
  
  
  METHODS
  General hospital with a specialized endometriosis unit.
  
  
  METHODS
  One hundred and eight women with symptoms suggestive of intestinal endometriosis who underwent DCBE before laparoscopic surgery.
  
  
  METHODS
  Laparoscopic complete excision of endometriosis.
  
  
  RESULTS
  Fifty-five patients were found to have an entirely normal colon on DCBE studies. Twenty-eight of these were found to have adhesions of the bowel at laparoscopy. Radiographic abnormalities suggestive of endometriosis were detected in 53 patients; 20 of these underwent laparoscopic bowel segmental resection, 10 laparoscopic full-thickness disc excision, 4 laparoscopic mucosal skinning, and 4 total laparoscopic hysterectomy with bilateral salpingo-oophorectomies. Fourteen patients refused intestinal surgery. One patient had no endometriosis but severe adhesions. In all cases but one, the radiographic findings on DCBE were confirmed by surgery and with histopathologic examination of the resected specimens (accuracy 99%). In these same cases, the preoperative choice of intestinal surgery remained unchanged during the procedure.
  
  
  CONCLUSIONS
  Our data show that, in expert hands, DCBE correlated with a patient's clinical history and clinical findings is capable of diagnosing bowel wall involvement due to endometriosis, which could require intestinal surgery. This allows for proper preoperative planning of surgical procedures and a thorough informed consent.
authors.affiliation: Department of Obstetrics and Gynecology, Ospedale Sacro Cuore, Negrar (Verona) Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Landi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Barbieri
authors.forename: Andrea
authors.initials: A
authors.lastname: Fiaccavento
authors.forename: Paride
authors.initials: P
authors.lastname: Mainardi
authors.forename: Giacomo
authors.initials: G
authors.lastname: Ruffo
authors.forename: Luigi
authors.initials: L
authors.lastname: Selvaggi
authors.forename: Radha
authors.initials: R
authors.lastname: Syed
authors.forename: Luca
authors.initials: L
authors.lastname: Minelli
mesh_terms: D000328:Adult; D001466:Barium Sulfate; D016022:Case-Control Studies; D003287:Contrast Media; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D004733:Enema / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate