Document Detail

Double-contrast barium enema and transrectal endoscopic ultrasonography in the diagnosis of intestinal deeply infiltrating endometriosis.
MedLine Citation:
PMID:  18439504     Owner:  NLM     Status:  MEDLINE    
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.
Helizabet Salomão Abdalla Ayroza Ribeiro; Paulo Ayroza Ribeiro; Lucio Rossini; Francisco Cesar Rodrigues; Nilson Donadio; Tsutomu Aoki
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of minimally invasive gynecology     Volume:  15     ISSN:  1553-4650     ISO Abbreviation:  -     Publication Date:    2008 May-Jun
Date Detail:
Created Date:  2008-04-28     Completed Date:  2008-08-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101235322     Medline TA:  J Minim Invasive Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  315-20     Citation Subset:  IM    
Obstetrics and Gynecology Department, Santa Casa Medical School, São Paulo, Brazil.
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MeSH Terms
Barium Sulfate / diagnostic use
Endometriosis / radiography*,  ultrasonography*
Endosonography / methods
Gastrointestinal Diseases / radiography*,  ultrasonography*
Middle Aged
Predictive Value of Tests
Prospective Studies
Reg. No./Substance:
7727-43-7/Barium Sulfate

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