Barium enema evaluation of colonic involvement in endometriosis.
OBJECTIVE
The purpose of our study was to define the role of double-contrast barium enema (DCBE) compared with laparoscopy in the diagnosis and local staging of intestinal endometriosis.


METHODS
A search of our radiology database revealed the cases of 234 women who underwent surgical resection for pelvic endometriosis with associated intestinal surgery for intestinal endometriosis. We retrospectively evaluated all preoperative DCBE images for the presence of bowel endometriosis and the number, site (rectum, sigmoid, cecum), and size of the lesions. The radiographic findings at DCBE were retrospectively correlated with those at surgical pathologic examination.


RESULTS
DCBE revealed 211 intestinal lesions of bowel endometriosis in 168 (71.8%) of 234 patients with pelvic endometriosis clinically enrolled. Forty (23.8%) of the 168 women had more than one endometriotic bowel nodule (two nodules in 37 cases, three in three cases). Laparoscopy revealed 233 intestinal lesions in 174 (74.3%) of the patients. Fifty-four (31.0%) of 174 women had more than one endometriotic bowel nodule (two nodules in 49 cases, three in five cases). There was 100% correlation between the DCBE and histologic findings as far as site and size of the lesions were concerned. DCBE had a sensitivity of 88.4%, specificity of 93.0%, positive predictive value of 97.5%, negative predictive of 71.0%, and accuracy of 89.5% in the identification of bowel endometriosis.


CONCLUSIONS
DCBE is helpful in discerning bowel wall involvement in endometriosis, enabling proper surgical planning. DCBE also appears to have a role in the management of endometriosis.
Faccioli
Niccolò
N
Department of Radiology, University of Verona, Policlinico G. B. Rossi, Piazzale Scuro 10, 37134 Verona, Italy. nfaccioli@sirm.org
Manfredi
Riccardo
R
Mainardi
Paride
P
Dalla Chiara
Emiliano
E
Spoto
Elide
E
Minelli
Luca
L
Mucelli
Roberto Pozzi
RP
D000328:Adult; D001466:Barium Sulfate; D003108:Colonic Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D003287:Contrast Media; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000601:surgery; D004733:Enema / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D011859:Radiography; D012189:Retrospective Studies
D003287:Contrast Media; D001466:Barium Sulfate