1. Intestinal Endometriosis

Abstract

Five cases of colorectal endometriosis, four in the rectum and one in the sigmoid, were reported. In three cases, endometriosis involved one side of the intestinal wall simulating to the submucosal tumor, but in other two cases, the intestine was secondarily involved by diffuse pelvic endometroiosis.Barium enema examination revealed localized defect or segmental narrowing. Abnormal mucosal patterns, transverse ridging and/or reticular structure, were seen in three cases. We think these mucosal abnormalities were derived from submucosal fibrosis which characterized the roentgenologic findings of intestinal endometriosis. Although we could not diagnose endometriosis by endoscopic biopsy alone, this is an important diagnostic method for endometriosis to exclude carcinoma except in false negative cases.Preoperative diagnosis of intestinal endometriosis is difficult, however we can strongly suspect it by clinical course, roentgenologic findings, especially transverse ridging and/or reticular mucosal pattern, and other examinations including endoscopic biopsy.If operation is performed, intraoperative biopsy is necessary for the final diagnosis. We can avoid radical cancer surgery in this benign condition by these diagnostic procedures, and more conservative operations such as excision of the intestinal wall or partial resection with anastomosis. should be recommended as the treatment of intestinal endometriosis.Lastly, twenty-four Japanese cases reported in detail were analysed.