Department of Abdominal Surgery, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium.
Leuven University Fertility Centre, Department of Obstetrics and Gynaecology, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium.
Best Pract Res Clin Gastroenterol. 2014 Feb;28(1):53-67. doi: 10.1016/j.bpg.2013.11.008. Epub 2013 Dec 2.
Endometriosis is a handicapping disease affecting young females in the reproductive period. It mainly occurs in the pelvis and affects the bowel in 3-37%. Endometriosis can cause menstrual and non-menstrual pelvic pain and infertility. Colorectal involvement results in alterations of bowel habit such as constipation, diarrhoea, tenesmus, and rarely rectal bleeding. A precise diagnosis about the presence, location and extent is necessary. Based on clinical examination, the diagnosis of bowel endometriosis can be made by transvaginal ultrasound, barium enema examination and magnetic resonance imaging. Multidisciplinary laparoscopic treatment has become the standard of care and depending on size of the lesion and site of involvement full-thickness disc excision or bowel resection is performed by an experienced colorectal surgeon. Anastomotic complications occur around 1%. Long-term outcome after bowel resection for severe endometriosis is good with a pregnancy rate of 50%.
子宫内膜异位症是一种影响生育期年轻女性的致残性疾病。它主要发生在盆腔，影响肠道的发生率为 3-37%。子宫内膜异位症可引起月经和非月经期间的盆腔疼痛和不孕。结直肠受累可导致肠习惯改变，如便秘、腹泻、里急后重，很少有直肠出血。需要明确存在、位置和程度。基于临床检查，结直肠子宫内膜异位症的诊断可通过经阴道超声、钡剂灌肠检查和磁共振成像进行。多学科腹腔镜治疗已成为标准治疗方法，根据病变的大小和受累部位，由有经验的结直肠外科医生进行全层圆盘切除或肠切除术。吻合并发症发生率约为 1%。对于严重子宫内膜异位症行肠切除术的长期预后良好，妊娠率为 50%。
