Sonographical and clinical aspects of hepatobiliary system in patients with adenomyosis and endometrioid ovarian cysts

Abstract

Objective: The purpose of this study was to evaluate the role of hepatobiliary system in patients with endometrioid ovarian cysts and adenomyosis for developing the treatment strategy for this patient population.

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Methods: Eighty-nine consecutive premenopausal non-pregnant women had laparotomy between October 1997 and October 1998 because of the presence of a persistent adnexal mass and adenomyosis. They underwent liver and biliary tract sonography, transvaginal ultrasonography. The ultrasonographic impression were compared with the histopathologic diagnosis.

Results: Pathological disorders of liver — hepatitis in 31 (34,8%) and biliary tract disorders — in 43 (48,3%) patients with endometrioma and adenomyosis. Hepatobiliary activity was assessed on the basis of the determination of blood biochemical parameters, hepatic parenchymatous clearance and phasic polarized light spectrum of bile, each subject underwent transvaginal and transabdominal ultrasonography.

Conclusion: The findings indicate that patients with endometrioid ovarian cysts and adenomyosis should be referred to the group at a high risk of disorders of hepatobiliary system. Endometrioma is one of the most common ovarian diseases in premenopausal women. Transvaginal ultrasonography has a good predictive capacity in the diagnosis of this kind of cyst and adenomyosis. The finding indicates that hepatotropic agents should be added to combined treatment of this category of patients.