The-role-of-bowel-preparation-prior-to-transvaginal

The role of bowel preparation prior to transvaginal ultrasound in the diagnosis
of rectosigmoid deeply infiltrating endometriosis
Abstract ID : 1386
Soumis par : Cristina Ros Le 2016-02-19 17:54:31
Nom de la catégorie : SEUD CONGRESS
Typologie : Communication orale / Oral communication
Statut : validé
Autorisation de diffusion : Yes/Oui
------------------------------------Objectives: To evaluate the benefit of bowel preparation (BP) before a transvaginal ultrasound (TVUS) and describe
intestinal nodules of deeply infiltrating endometriosis (DIE).
Methods: The wall of the rectum and lower sigmoid of patients with suspected endometriosis was evaluated by two
TVUS: first ultrasound was performed without a previous BP and the second, after three-day low-residue diet and two
enemas of 250 ml (12h and 3h before TVUS). Intestinal involvement was considered when the lesion affected at least
the muscularis propia.
Results: 132 patients were included in the study, with a mean age of 36.6 ± 5.2 years. Variables were clearly more
?evaluable? with BP than without it, especially the percentage of the circumference of the bowel infiltrated and the
affection of the lower sigmoid. Up to 65% of adherences to the serosa layer identified during the first exam were
evaluated as real intestinal nodules after BP. Conversely, when intestinal infiltration was not suspected or not evaluable
without BP, a 5% and 27% of patients respectively, presented intestinal lesions after BP. When a rectosigmoid nodule
was suspected without BP, this lesion was confirmed in 89% of the cases. Considering the sub-group of patients with an
evaluable rectum during the first exam (109 out of 132 women; 82.6%), up to 10 nodules observed in the second TVUS
were not detected without BP, representing 1 nodule less than 11 patients examined without BP (p=0.003). In the
population studied, the nodules measured 29.77±12.44 mm long, 9.10±2.62 mm deep and 12.21±4.11 mm transverse
on average without BP. After BP, the measurements of the three axes of the nodules had an average of 35.53±12.00
mm, 11.00±2.90 mm and 14.21±4.99 mm respectively. The visualization of the intestinal wall with the BP used in the
study was correct in the 81.8% of cases.
Conclusions: TVUS with BP permits to detect more rectal nodules of DIE in patients with suspected endometriosis. The
nodules seem longer, deeper and affecting more rectal layers after BP. Detailed ultrasound parameters are frequently
non-evaluable without BP.
------------------------------------Mots clefs : bowel preparation, DIE
Auteurs :
Références : , , ,
Auteurs
Cristin Ros 1, Maria José Martínez-Serrano 1, Mariona Rius 1, Maria Àngels Martínez-Zamora 1, Meritxell Gracia 1,
Juan Balasch 1, Francisco Carmona 2,
1. Endometriosis unit, ICGON, Hospital clínic, Barcelona, SPAIN
2. Endometriosis unit, ICGON, Hospital clínicna, Barcelona, SPAIN
Auteurs (raw format)
Ros Cristin - email : [email protected] Etablissement : Hospital clínic Service : Endometriosis unit, ICGON Ville :
Barcelona Pays : SPAIN Présentateur : Oui
Martínez-Serrano Maria José - email : [email protected] Etablissement : Hospital clínic Service : Endometriosis
unit, ICGON Ville : Barcelona Pays : SPAIN Présentateur : Non
Rius Mariona - email : [email protected] Etablissement : Hospital clínic Service : Endometriosis unit, ICGON Ville :
Barcelona Pays : SPAIN Présentateur : Non
Martínez-Zamora Maria Àngels - email : [email protected] Etablissement : Hospital clínic Service : Endometriosis
unit, ICGON Ville : Barcelona Pays : SPAIN Présentateur : Non
Gracia Meritxell - email : [email protected] Etablissement : Hospital clínic Service : Endometriosis unit, ICGON
Ville : Barcelona Pays : SPAIN Présentateur : Non
Balasch Juan - email : [email protected] Etablissement : Hospital clínic Service : Endometriosis unit, ICGON Ville :
Barcelona Pays : SPAIN Présentateur : Non
Carmona Francisco - email : [email protected] Etablissement : Hospital clínicna Service : Endometriosis unit,
ICGON Ville : Barcelona Pays : SPAIN Présentateur : Non