Intestinal endometriosis: Diagnostic ambiguities and surgical outcomes

Table 1 Baseline characteristic of patients with intestinal endometriosis

Characteristics	n (%)
Age, yr, median (range)	43 (29-53)
Previous abdominal surgery	15 (50.0)
Pelvic surgery	13 (43.3)
Cesarean section	9 (30.0)
TAH ± BSO	4 (13.3)
Splenectomy	1 (3.3)
History of endometriosis	10 (33.3)
Surgical treatment	9 (30.0)
Ovarian cystectomy	3 (10.0)
TAH ± SO	2 (6.6)
Oophorectomy	2 (6.6)
Adhesiolysis	2 (6.6)
Medical treatment	7 (23.3)
Both	6 (20.0)
Initial symptom
Dysmenorrhea	9 (30.0)
Hematochezia	5 (16.7)
Abdominal pain	4 (13.3)
Constipation	2 (6.7)
Abdominal mass	1 (3.3)
Urinary discomfort	1 (3.3)
Diarrhea	1 (3.3)
No symptom	7 (23.3)

TAH: Total abdominal hysterectomy; BSO: Bilateral salpingo-oophorectomy.

Table 2 Preoperative computed tomography and colonoscopic findings

Findings	n (%)
Computed tomography
Eccentric intestinal wall thickening with a mass	15 (50.0)
Mass in the ovary or uterus	8 (26.7)
Intestinal stricture without a mass	4 (13.3)
Not definite	3 (10.0)
Colonoscopy
Eccentric wall thickening without mucosal change	8 (26.7)
Eccentric wall thickening with mucosal change	8 (26.7)
Normal	4 (13.3)
Not evaluated	10 (33.3)
Colonoscopic biopsy
Inflammation	6 (20.0)
Endometriosis	4 (13.3)
Adenoma	2 (6.7)
Normal mucosa	1 (3.3)
Not evaluated	17 (56.7)

Table 3 Categories of preoperative diagnosis

Preoperative diagnosis	n (%)
Pelvic endometriosis	13 (43.3)
Rectosigmiod endometriosis	9 (30.0)
Rectovaginal endometriosis	2 (6.7)
Ovarian endometrioma	2 (6.7)
Malignancy	7 (23.3)
Colorectal cancer	3 (10.0)
Ovarian cancer	3 (10.0)
Small intestinal cancer	1 (3.3)
Other disease	10 (33.3)
Colorectal submucosal tumor	8 (26.7)
Crohn’s disease with intestinal stricture	1 (3.3)
Postoperative adhesion of the small intestine	1 (3.3)

Table 4 Locations of intestinal endometriosis in surgical specimens

Location	n (%)
Rectum	19 (63.3)
Sigmoid colon	6 (20.0)
Ileum	3 (10.0)
Cecum	2 (6.7)

Table 5 Types of operations for intestinal endometriosis

Operations	n (%)
Type of intestinal operation
Low anterior resection	15 (50.0)
Anterior resection	10 (33.3)
Ileocecal resection	3 (10.0)
Cecectomy	1 (3.3)
Resection and anastomosis of the small intestine	1 (3.3)
Type of combined operation
TAH ± SO	7 (23.3)
Ovarian cystectomy	4 (13.3)
SO	3 (10.0)
Posterior vaginectomy	1 (3.3)
Ureteroureterostomy	1 (3.3)
None	14 (46.7)

TAH: Total abdominal hysterectomy; BSO: Bilateral salpingo-oophorectomy.

Table 6 Postoperative complications within 30 d after the operation

Complication	n (%)	Clavien-Dindo classification
		I	II	IIIa	IIIb
Pelvic abscess	3 (10.0)	0	1	2	0
Paralytic ileus	3 (10.0)	3	0	0	0
Acute pyelonephritis	1 (3.3)	0	1	0	0
Total	7 (23.3)	3	2	2	0