SYMPTOMATIC BOWEL ENDOMETRIOSIS

SYMPTOMATIC BOWEL ENDOMETRIOSIS

 

 

In all cases, sigmoidoscopic examination for tender, fixed angulation of bowel is followed by double contrast barium enema. Selective colono­scopy. Mechanical and antibiotic bowel preparation in all cases. Estrogen hormone replacement therapy in patients without ovaries.

 

  1. Conservative surgery for endometriosis and extraluminal, wedge, or segmental bowel resection
  2. Excision of all pelvic endometriosis and hysterectomy with ovarian conservation and extraluminal, wedge, or segmental bowel resection
  3. Excision of all pelvic endometriosis and hysterectomy, bilateral salpingo- oophorectomy, and extraluminal, wedge, or segmental bowel resection

 

  1. Partial bowel obstruction

 

  1. Frozen section to rule out malignancy
  2. Wedge or segmental bowel resection
  3. Primary anastomosis if possible, colostomy if necessary

 

  1. Complete bowel obstruction

 

  1. Frozen section to rule out malignancy
  1. Colostomy to relieve bowel obstruction
  2. Secondary bowel resection and closure of colostomy

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