| Double-contrast barium enema and transrectal endoscopic ultrasonography in the diagnosis of intestinal deeply infiltrating endometriosis. | |
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MedLine Citation:
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PMID: 18439504 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY OBJECTIVE: To evaluate the sensitivity, specificity, negative predictive value, positive predictive value, association, and agreement of double-contrast barium enema (DCBE) and transrectal endoscopic ultrasonography (Tr EUS) in the diagnosis of rectosigmoid colon endometriosis. DESIGN: Prospective nonrandomized (Canadian Task Force classification II-2). SETTING: University hospital. PATIENTS: We evaluated 37 patients with clinically suspected deeply infiltrating endometriosis (DIE) from January 2004 through January 2005. INTERVENTIONS: Clinical examination, DCBE, Tr EUS, and laparoscopy for histologic confirmation. MEASUREMENTS AND MAIN RESULTS: Deeply infiltrating endometriosis was confirmed by laparoscopic visualization and by histopathologic examination in all patients. Intestinal endometriosis was observed in 27 patients (72.9%). DCBE showed abnormalities suggestive of bowel endometriosis in 24 patients (64.9%) and Tr EUS in 28 patients (75.7%). Considering the DCBE findings we observed among the 24 abnormal examination results, 16 (42.3%) had spiculation, 16 (42.3%) had circumferential narrowing of the bowel, and 4 (10.8%) had the mass effect sign. For DCBE the sensitivity was 88%, the specificity was 54%, the negative predictive value (NPV) was 70%, and the positive predictive value (PPV) was 78%. For Tr EUS the sensitivity, specificity, NPV, and PPV were 96%, 100%, 90%, and 100%. A significant association of the DCBE and the Tr EUS in the diagnosis of intestinal DIE (p = .017) and a moderate agreement of the methods (kappa = 0.44) was also observed. CONCLUSION: Our data, although limited by sample size, confirmed that DCBE has a good sensitivity and a low specificity in the diagnosis of intestinal DIE. The Tr EUS proved to have a higher sensitivity and specificity with elevated NPV and PPV. A significant association of the DCBE and the Tr EUS in the diagnosis of intestinal DIE and a moderate agreement of the methods was also observed. |
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Authors:
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Helizabet Salomão Abdalla Ayroza Ribeiro; Paulo Ayroza Ribeiro; Lucio Rossini; Francisco Cesar Rodrigues; Nilson Donadio; Tsutomu Aoki |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of minimally invasive gynecology Volume: 15 ISSN: 1553-4650 ISO Abbreviation: - Publication Date: 2008 May-Jun |
Date Detail:
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Created Date: 2008-04-28 Completed Date: 2008-08-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101235322 Medline TA: J Minim Invasive Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 315-20 Citation Subset: IM |
Affiliation:
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Obstetrics and Gynecology Department, Santa Casa Medical School, São Paulo, Brazil. hsabdalla@uol.com.br |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Barium Sulfate / diagnostic use Endometriosis / radiography*, ultrasonography* Endosonography / methods Female Gastrointestinal Diseases / radiography*, ultrasonography* Humans Middle Aged Predictive Value of Tests Prospective Studies |
| Chemical | |
Reg. No./Substance:
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7727-43-7/Barium Sulfate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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