Ultrasound Differential Diagnosis in Deep Infiltrating Endometriosis of the Urinary Tract.

Endometriosis of the urinary tract is a rare condition that may lead to severe complications. At present, the major challenge appears to be the ultrasound differential diagnosis with diseases that can afflict the ureter and the bladder. Preoperative scan findings were compared with surgical and histologic records. Twenty-three cases were selected as being of interest, as they were referred for suspected endometriosis, whereas second-level ultrasound revealed a different disease in some cases. This case series aims to help in becoming familiar with the possible differential diagnosis of lesions of the urinary tract that resemble endometriosis.

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. MATERIALS AND 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. CONCLUSION: 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.