ENDOSCOPIC DIAGNOSIS OF COLORECTAL ENDOMETRIOSIS

Objective. To study and systemize the endoscopic signs of colorectal endometriosis and to assess the role of colonoscopy in its diagnosis. Subjects and methods. Three hundred and twenty diagnostic colonoscopies carried out in patients admitted to the clinic for the diagnosed infiltrative external genital endometriosis in March 2011 to November 2012 were analyzed. Results. Among all detected intestinal endometriosis cases (n=67), the pathological process was located most frequently in the upper ampullary segment of the rectus in 38 (56.7%) cases and less often in the lower ampullary segment of the rectus and anal canal in 5 (7.4%). Multifocal intestinal lesion was found in 6 (8.9%) cases. The significant signs of colorectal endometriosis were detectable in mucosal lesion and included polypoid growths above the focus of endometriosis in 15 (22.4%) cases, endometrioid heterotopias on the colonic mucosa in 7 (10.4%), mucosal ulcerations in the projection of a focus of endometriosis in 4 (5.9%), and mucosal undulations in 3 (4.5%). Conclusion. Colonoscopy is a basic diagnostic method for colorectal endometriosis. The negative histological response in the biopsy specimen obtained at colonoscopy does not rule out colonic involvement with endometriosis. Colorectal endometriosis may be systemized by the following endoscopic signs: the site of a pathological focus, the pattern of growth; the presence of mucosal lesion.

colorectal endometriosis, infiltrative endometriosis, cyclic rectal bleeding, endoscopic studies, colonoscopy