Browse > Article

Rectal Endometriosis That Is Difficult to Differentiate from Endoscopically Resectable Subepitherial Lesion  

Chung, Seung-Kyu (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Lee, Suck-Ho (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Son, Bum-Suk (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Lee, Chang-Kyun (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Lee, Tae-Hoon (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Chung, Il-Kwun (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Kim, Sun-Joo (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Lee, Ji-Hye (Department of Pathology, Cheonan Hospital, Soonchunhyang University College of Medicine)
Publication Information
Clinical Endoscopy / v.41, no.5, 2010 , pp. 319-323 More about this Journal
Abstract
Endometriosis occurs most frequently in the intestine. In the pelvic organs intestinal endometriosis presents with various symptoms and endoscopic findings. If an asymptomatic submucosal lesion is found in the sigmoid colon or rectum of reproductive women, a differential diagnosis should be done. Owing to advancements in endoscopic therapy, endoscopic excision has been attempted for various subepithelial lesions. To successfully do an endoscopic excision, accurate diagnosis should be obtained through diagnostic tests such as endoscopic ultrasonography prior to excision. Here the authors report a case of rectal endometriosis in an asymptomatic woman of reproductive age. They attempted endoscopic resection based on the endoscopic finding that the subepithelial lesion was limited to the submucosal layer in endoscopic ultrasonography. This conclusion turned out to be a mistaken one. Because of tumor adhesion to the proper muscular layer, we failed to successfully conduct an endoscopic excision. Ultimately, we did surgery and diagnosed rectal endometriosis.
Keywords
Endometriosis; Subepitherial lesion; Endoscopic ultrasonography; Endoscopic resection;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Jubanyik KJ, Comite F. Extrapelvic endometriosis. Obstet Gynecol Clin North Am 1997;24:411-440.   DOI   ScienceOn
2 Schroder J, Lohnert M, Doniec JM, Dohrmann P. Endoluminal ultrasound diagnosis and operative management of rectal endometriosis. Dis Colon Rectum 1997;40:614-617.   DOI   ScienceOn
3 Puglielli E, Di Cesare E, Masciocchi C. Rectal endometriosis: MRI study with rectal coil. Eur Radiol 2004;14:2362-2363.   DOI   ScienceOn
4 Shaw A, Lund JN, Semeraro D, Cartmill M, Reynolds JR, Tierney GM. Large bowel obstruction and perforation secondary to endometriosis complicated by a ventriculoperitoneal shunt. Colorectal Dis 2008;10:520-521.   DOI   ScienceOn
5 Gress F, Schmitt C, Savides T, et al. Interobserver agreement for EUS in the evaluation and diagnosis of submucosal masses. Gastrointest Endosc 2001;53:71-76.   DOI   ScienceOn
6 Shim CS, Jung IS. Endoscopic removal of submucosal tumors: preprocedure diagnosis, technical options, and results. Endoscopy 2005;37:646-654.   DOI   ScienceOn
7 Bozdech JM. Endoscopic diagnosis of colonic endometriosis. Gastrointest Endosc 1992;38:568-570.   DOI   ScienceOn
8 Chu PW, Su HY, Ko CS. Endometriosis of the colon and rectum mimicking colon cancer. Int J Gynaecol Obstet 2004;87:167-168.   DOI   ScienceOn
9 Doniec JM, Kahlke V, Peetz F, et al. Rectal endometriosis: high sensitivity and specificity of endorectal ultrasound with an impact for the operative management. Dis Colon Rectum 2003;46:1667-1673.   DOI   ScienceOn
10 Roseau G, Dumontier I, Palazzo L, et al. Rectosigmoid endometriosis: endoscopic ultrasound features and clinical implications. Endoscopy 2000;32:525-530.   DOI   ScienceOn
11 Olive DL, Schwartz LB. Endometriosis. N Engl J Med 1993;328:1759-1769.   DOI   ScienceOn
12 Weed JC, Ray JE. Endometriosis of the bowel. Obstet Gynecol 1987;69:727-730.
13 Kameyama H, Niwa Y, Arisawa T, Goto H, Hayakawa T. Endoscopic ultrasonography in the diagnosis of submucosal lesions of the large intestine. Gastrointest Endosc 1997;46:406-411.   DOI   ScienceOn
14 Park YS, Park SW, Kim TI, et al. Endoscopic enucleation of upper-GI submucosal tumors by using an insulated-tip electrosurgical knife. Gastrointest Endosc 2004;59:409-415.   DOI   ScienceOn
15 Yamaguchi N, Isomoto H, Nishiyama H, et al. Endoscopic submucosal dissection for rectal carcinoid tumors. Surg Endosc 2010;24:504-508.   DOI   ScienceOn
16 Lee IL, Lin PY, Tung SY, Shen CH, Wei KL, Wu CS. Endoscopic submucosal dissection for the treatment of intraluminal gastric subepithelial tumors originating from the muscularis propria layer. Endoscopy 2006;38:1024-1028.   DOI   ScienceOn