Ileocecal endometriosis Clinical and pathogenetic implications of an underdiagnosed condition

Capsule:
The radical surgical resection of associated ileocecal andrectovaginal endometriosis reduces pelvicpain, constipation, and dyschezia during a long-term follow-up.

Authors:
Luigi Fedele, M.D., Nicola Berlanda, M.D., Carlo Corsi, M.D., Giacomo Gazzano, M.D., Martina Morini, M.S., Paolo Vercellini, M.D.

Volume 101, Issue 3, Pages 750-753, March 2014

Abstract:

Objective:
To review our experience with surgical treatment of ileocecal endometriosis.

Design:
Observational study.

Setting:
Tertiary university hospital in Italy.

Patient(s):
Eight consecutive patients with infiltrating ileocecal endometriosis operated on between 2003 and 2005.

Intervention(s):
All of the women underwent laparotomic ileocecal or cecal resection and had radical treatment of rectovaginal endometriosis as well.

Main Outcome Measure(s):
Long-term relief of pelvic pain, constipation, and dyschezia.

Result(s):
There were no postoperative intestinal complications. At a mean ± SD follow-up of 106 ± 10 months, all of the patients reported significant improvement of pelvic pain and bowel symptoms.

Conclusion(s):
Infiltrating ileocecal endometriosis requiring bowel resection was associated in all cases with infiltrating rectovaginal endometriosis, possibly reflecting a common pathogenesis. A thorough clinical evaluation of women with rectovaginal endometriosis might allow an improvement in the difficult preoperative diagnosis of ileocecal endometriosis. Our data support the long-term efficacy of the radical surgical resection of associated ileocecal and rectovaginal endometriotic lesions in reducing pelvic pain, constipation, and dyschezia.