OBJECTIVETo study the diagnosis and therapy of the rectovaginal endometriosis.

METHODSClinical data of 57 women with rectovaginal endometriosis admitted to the West China Second University Hospital of Sichuan University in last two years,were retrospectively reviewed.

RESULTThe average age of patients was 40.1 years. The main clinical manifestations were dysmenorrheal, changes of menorrhea and digestive stimulation. The diameter of deep endometriosis nodules was between 1-6 cm, and 77% were found to have more than one nodules. Seven of these patients had positive results in transvaginal ultrasonography; 61%(11/18) patients had elevated CA125 levels. Thirteen patients were given preoperational medical treatment, but had no effect. All patients, except one accepted laparotomic therapy of complete excision of endometriosis nodules; 23 cases underwent drug therapy after operation. No patients had recurrence in recto-vaginal septum after complete excision; only one recurred in right ovary. Patients who failed to remove the total lesion showed improvement in pain.

CONCLUSIONDiagnosis of the rectovaginal endometriosis is based on symptoms, vaginal and rectal examination, and auxiliary examination. Complete excision of endometriosis nodules is the main therapeutic method.

Adult ; Dysmenorrhea ; etiology ; Endometriosis ; classification ; diagnosis ; surgery ; Endosonography ; methods ; Female ; Humans ; Laparoscopy ; methods ; Middle Aged ; Rectal Diseases ; diagnosis ; surgery ; Retrospective Studies ; Vaginal Diseases ; diagnosis ; surgery

No abstract available.
Aged ; Colonoscopy ; Enema/*adverse effects ; Humans ; Intestinal Perforation/*diagnosis/etiology ; Male ; Rectal Diseases/*diagnosis/diagnostic imaging/etiology ; Tomography, X-Ray Computed

The clinicopathological findings in previous studies concerning food protein-induced proctocolitis (FPIPC) are quite diverse in terms of results and conclusions. The aim of this study was to suggest advanced clinicopathological diagnostic criteria that facilitate the early confirmation of FPIPC. Data of 38 FPIPC patients, who had received sigmoidoscopy and biopsy, was analyzed. Microscopic findings were compared with observations of previous studies. Feeding at onset of bleeding was exclusively breast-fed (94.7%) and formula-fed or mixed-fed (5.3%). Endoscopic abnormalities were observed in all patients; nodular hyperplasias with circumscribed and/or central pit-like erosions in 94.7% and erythema in 5.3%. Histopathological findings were; lymphoid aggregates in 94.7%, eosinophils in lamina propria of > or =60 cells/10 HPF in 97.4% and of >20 cells/HPF in 63.2%, epithelial or muscularis mucosa eosinophil infiltration in 97.4%, and crypt abscess in 2.6%. The majority of FPIPC patients are exclusively breast-fed and nodular hyperplasias with erosions may be a disease specific endoscopic finding. Histologic diagnosis of FPIPC is compatible with eosinophils in the lamina propria of > or =60 cells/10 high power fields; however, >20 cells/HPF is not an appropriate diagnostic criterion.
Sensitivity and Specificity ; Reproducibility of Results ; Rectal Diseases/*diagnosis/etiology ; Proctocolitis/*diagnosis/*etiology ; Male ; Infant, Newborn ; Infant ; Humans ; Gastrointestinal Hemorrhage/*diagnosis/etiology ; Female ; Dietary Proteins/*adverse effects ; Diagnosis, Differential ; Breast Feeding/*adverse effects

To elevate the clinical value of 3D-FLASH in the diagnosis of anal fistula and compare it with convertioned MR sequence, MR sequences, consisting of spin echo T1WI, turbo invertion recovery magnitude (TIRM), fast low-angle shot image (FLASH), mon-enhancement and enhancement substraction and coronary reconstructing, was conducted in 15 cases suspected of anal fistula. Comparison was made among the three sequences in display rate of internal fistula, external fistula, the branch of fistule connulas. Our results showed that 1 patient had perianal abscess. 24 different anal fistulas were identified in 14 patients, and 10 of them was complicated with perianal abscess and 8 of them with complex multi-branch fistula. The display rate of 3D-FLASH sequence was much higher than those of T1WI and TIRM in all cases. It is concluded that 3D-FLASH sequence is an senstive and time-efficient technique for the diagnosis of anal fistula.
Abscess ; diagnosis ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anus Diseases ; diagnosis ; Colonic Diseases ; complications ; diagnosis ; Colonography, Computed Tomographic ; methods ; Contrast Media ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; methods ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Radiographic Image Enhancement ; Rectal Fistula ; diagnosis ; etiology ; Sensitivity and Specificity

A Dieulafoy lesion in the rectum is a very rare and it can cause massive lower gastrointestinal bleeding. An 83-year-old man visited our hospital. He had chronic constipation and had taken aspirin for about 10 years because of a previous brain infarction. He was admitted because of a recent brain stroke. On the third hospital day, he had massive hematochezia and suddenly developed hypovolemic shock. Abdominal computed tomography showed active arterial bleeding on the left side of the mid-rectum. Emergency sigmoidoscopy showed an exposed vessel with blood spurting from the rectal wall. The active bleeding was controlled successfully by an injection of epinephrine and two hemoclippings. On the fourth day after the procedure, he had massive recurrent hematochezia, and his vital signs were unstable. Doppler-guided hemorrhoidal artery band ligation was performed urgently at two sites. However, he rebled on the third postoperative day. Selective inferior mesenteric angiography revealed an arterial pseudoaneurysm in a branch of the superior rectal artery, as the cause of rectal bleeding, and this was embolized successfully. We report a rare case of life-threatening rectal bleeding caused by a Dieulafoy lesion combined with pseudoaneurysm of the superior rectal artery which was treated successfully with embolization.
Aged, 80 and over ; Aneurysm/radiography ; Angiography ; Aspirin/therapeutic use ; Brain Infarction/drug therapy/prevention & control ; Embolization, Therapeutic ; Gastrointestinal Hemorrhage/*diagnosis/etiology/therapy ; Hemorrhoids/*complications ; Humans ; Male ; Mesenteric Artery, Inferior/radiography ; Platelet Aggregation Inhibitors/therapeutic use ; Rectal Diseases/complications/diagnosis/therapy ; Rectum/blood supply ; Sigmoidoscopy ; Tomography, X-Ray Computed

A Dieulafoy lesion in the rectum is a very rare and it can cause massive lower gastrointestinal bleeding. An 83-year-old man visited our hospital. He had chronic constipation and had taken aspirin for about 10 years because of a previous brain infarction. He was admitted because of a recent brain stroke. On the third hospital day, he had massive hematochezia and suddenly developed hypovolemic shock. Abdominal computed tomography showed active arterial bleeding on the left side of the mid-rectum. Emergency sigmoidoscopy showed an exposed vessel with blood spurting from the rectal wall. The active bleeding was controlled successfully by an injection of epinephrine and two hemoclippings. On the fourth day after the procedure, he had massive recurrent hematochezia, and his vital signs were unstable. Doppler-guided hemorrhoidal artery band ligation was performed urgently at two sites. However, he rebled on the third postoperative day. Selective inferior mesenteric angiography revealed an arterial pseudoaneurysm in a branch of the superior rectal artery, as the cause of rectal bleeding, and this was embolized successfully. We report a rare case of life-threatening rectal bleeding caused by a Dieulafoy lesion combined with pseudoaneurysm of the superior rectal artery which was treated successfully with embolization.
Aged, 80 and over ; Aneurysm/radiography ; Angiography ; Aspirin/therapeutic use ; Brain Infarction/drug therapy/prevention & control ; Embolization, Therapeutic ; Gastrointestinal Hemorrhage/*diagnosis/etiology/therapy ; Hemorrhoids/*complications ; Humans ; Male ; Mesenteric Artery, Inferior/radiography ; Platelet Aggregation Inhibitors/therapeutic use ; Rectal Diseases/complications/diagnosis/therapy ; Rectum/blood supply ; Sigmoidoscopy ; Tomography, X-Ray Computed