G Chir. 2010
Mar;31(3):100-2.
Occlusione
intestinale acuta da endometriosi ileale trattata in laparoscopia.
Case report.
[Article
in Italian]
Feroci F, De
Prizio M, Kröning KC, Moraldi L, Scatizzi M.
Verisione
italiana Riassunto: Occlusione intestinale acuta da endometriosi
ileale trattata in laparoscopia. Case report. F. Feroci, M. De
Prizio, K.C. Kröning, L. Moraldi, M. Scatizzi Il 10-20% delle donne
in età fertile è affetto da endometriosi. La sua localizzazione
ileale, solitamente nel tratto terminale, è solo del 7%.
L’occlusione intestinale si verifica in non più dello 0,15% delle
pazienti affette da endometriosi. Presentiamo un caso di occlusione
intestinale acuta da endometriosi ileale, in una donna di 39 anni, in
cui l’approccio diagnostico e terapeutico è stato condotto per via
laparoscopico. English version Summary:
Laparoscopic approach in acute bowel obstruction due to ileal
endometriosis: case report. F. Feroci, M. De Prizio, K.C. Kröning,
L. Moraldi, M. Scatizzi Endometriosis affects 10-20% of fertile
women, and in 3-37% of them it extends to the bowel. Its location, in
the ileal tract of the bowel, usually the end-part, is only the 7%;
and the occurrence of intestinal obstruction is no more than 0.15% of
patients affected by endometriosis. We present a case of acute bowel
obstruction due to ileal endometriosis in a 39 years woman, diagnosed
and treated by laparoscopic approach.
N
Z Med J. 2010 Apr 9;123(1312):77-80.
Non-classic
congenital adrenal hyperplasia due to 21-hydoxylase deficiency as a
cause of infertility and miscarriages.
Falhammar
H.
Department
of Endocrinology, Cairns Base Hospital, PO Box 902, Cairns, QLD 4870,
Australia. henrik.falhammar@ki.se
The
extragonadal manifestations of intestinal endometriosis necessitating
immediate abdominal surgical exploration are, to date, sparsely
represented within the literature. We present two cases of acute
complete small and large bowel obstruction secondary to
endometriosis, requiring emergent laparotomy; and review the
pertinent literature.
Reprod
Biomed Online. 2010 May;20(5):602-609. Epub
2010 Feb 1.
Fertility
and clinical outcome after bowel resection in infertile women with
endometriosis.
Stepniewska A,
Pomini P, Scioscia M, Mereu L, Ruffo G, Minelli L.
Department of
Obstetrics and Gynecology, Ospedale Sacro Cuore, Via Don Sempreboni
5, 37024 Negrar, Verona, Italy.
Bowel
resection for endometriosis improves pain symptoms and quality of
life in symptomatic women. However, little is known about fertility
after surgery, particularly after such treatment in women suffering
from infertility. The aim of the present study was to evaluate
post-operative fertility and long-term clinical outcome after
laparoscopic colorectal resection for endometriosis in infertile
women. This study reports clinical outcomes in 62 infertile women who
underwent laparoscopic excision of endometriosis with segmental bowel
resection performed for severe intestinal symptoms. Among women
younger than 30years trying to conceive spontaneously, the cumulative
pregnancy rate was 58% and the cumulative pregnancy rate was 45% in
those aged 30-34 years. The total pain recurrence was 9.7% (six
cases) and endometriosis recurrence was diagnosed by ultrasound in
14.5% (nine cases) during the follow-up period. Four of these
patients needed further surgery because of severe symptoms. The
surgical treatment of bowel endometriosis seems to improve pain
symptoms and patients’ satisfaction rates, and it could also be
indicated in infertile women. Copyright © 2010 Reproductive
Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
Eur
J Obstet Gynecol Reprod Biol. 2010 Mar 11.
[Epub ahead of print]
Letrozole and
norethisterone acetate in colorectal endometriosis.
Ferrero S,
Camerini G, Ragni N, Venturini PL, Biscaldi E, Seracchioli R,
Remorgida V.
Department
of Obstetrics and Gynaecology, San Martino Hospital and University of
Genoa, Largo R. Benzi 1, 16132 Genoa, Italy.
OBJECTIVE:
Up to now limited attention has been given to the medical treatment
of bowel endometriosis. This study evaluates the efficacy of
aromatase inhibitors and norethisterone acetate in treating pain and
gastrointestinal symptoms caused by bowel endometriosis. STUDY
DESIGN: This prospective pilot study included six women with
colorectal endometriosis; all women had intestinal nodules
infiltrating at least the muscularis propria of the bowel and did not
have a stenosis of the bowel lumen >60%; the patients suffered
from pain and intestinal symptoms. The study subjects received
letrozole (2.5mg/day) and norethisterone acetate (2.5mg/day)
continuously for 6 months. The presence and intensity of symptoms
were evaluated before starting the treatment, and after 3 and 6
months of treatment. RESULTS: The double-drug regimen improved pain,
non-menstrual pelvic pain, deep dyspareunia, dyschezia, symptoms
mimicking diarrhoea-predominant irritable bowel syndrome, intestinal
cramping, abdominal bloating and passage of mucus in the stools, and
67% of the patients declared that the treatment improved their
gastrointestinal symptoms. CONCLUSIONS: The administration of
letrozole and norethisterone acetate reduces pain and
gastrointestinal symptoms of women with colorectal endometriosis,
particularly when patients suffer from symptoms mimicking
diarrhoea-predominant irritable bowel syndrome. Copyright © 2010.
Published by Elsevier Ireland Ltd.
JSLS.
2009 Oct-Dec;13(4):496-503.
Laparoscopic
excision of endometriosis may require unilateral parametrectomy.
Landi S, Mereu
L, Indraccolo U, Favero R, Fiaccavento A, Zaccoletti R, Clarizia R,
Barbieri F.
Department
of Obstetrics and Gynecology, Ospedale Sacro Cuore, Verona, Italy.
OBJECTIVE:
We investigated the effects of laparoscopic excision of endometriosis
with unilateral parametrectomy on bladder, rectal, and sexual
function as well as patient satisfaction. METHODS: Women who
underwent this procedure between February 1, 2006 and November 15,
2007 were enrolled. Patient characteristics, pre- and postoperative
findings, and follow-up data were retrospectively collected from a
computerized database. RESULTS: Twelve patients were enrolled in the
study. All of the symptoms except dysuria improved after surgery,
worsening long after the operation. It seems that all parameters
including sexuality, micturition, and defecation are equally
important in regards to the final judgement of satisfaction, with a
trend towards amelioration long after the operation. CONCLUSIONS:
Unilateral parametrectomy may offer successful results in terms of
patient satisfaction despite some impairment in bladder, bowel, and
sexual function. The risk of permanent functional impairment is high;
therefore, surgeons need to maintain the integrity of the
contralateral nerve pathway. This is highly important, because pain
relief seems to be partially involved in the final judgement of
postoperation satisfaction.
Eur
J Gastroenterol Hepatol. 2010
Mar;22(3):374-5.
Ileal
intubation with a transnasal endoscope.
Pietropaolo V,
Hassan C, Pontone S, Onorato M, Pedretti G, Zullo A.
Digestive
Endoscopy Unit, La Sapienza University, Rome, Italy.
Transnasal
upper endoscopy has been implemented in the last decade as it is
perceived as less fastidious than peroral endoscopy, and
small-caliber gastroscopes are widely available in the endoscopic
centres. We report the feasibility of performing a full colonic study
with ileal intubation, using a small-caliber endoscope commonly used
for transanal endoscopy, after failing with a standard gastroscope.
World
J Gastroenterol. 2010 Feb 7;16(5):648-51.
Rectal
perforation from endometriosis in pregnancy: case report and
literature review.
Pisanu A,
Deplano D, Angioni S, Ambu R, Uccheddu A.
Department of
Surgery, Clinica Chirurgica, University of Cagliari, Ospedale San
Giovanni di Dio, Via Ospedale 46, 09124, Cagliari, Italy.
adolfo.pisanu@unica.it
This
case report describes a woman with spontaneous rectal perforation
from decidualized endometriosis in pregnancy. A 37-year-old woman was
admitted to our hospital at 30 wk of pregnancy with symptoms
suggestive of pyelonephritis, which persisted until 33 wk of
gestation when delivery of a premature male baby was performed
through a cesarean section. On postoperative day 2, an abdominal
computed tomography showed free air in the peritoneal cavity and a
pelvic abscess. Explorative celiotomy revealed a diffuse severe
fecaloid peritonitis that originated from a 3-cm wide rectal
perforation. A Hartmann operation was then performed.
Histopathological findings were consistent with decidualization of
the rectal wall. Only 20 cases of intestinal perforation due to
endometriosis have been reported in the literature. This report is
believed to be the first case of spontaneous rectal perforation from
endometriosis in pregnancy, and it shows the potential occurrence of
serious and unexpected complications of the disease.
Praxis
(Bern 1994). 2010 Feb 3;99(3):200-2.
CME–ultrasound
diagnosis. Dysuria in a young woman.
[Article in
German]
Tuma
J, Trinkler F.
Präsident
Ausbildungskommission, Schweizerische Gesellschaft für Ultraschall
in der Medizin, Seilweg 1, 8610 Uster. jan.tuma@access.uzh.ch