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THE MANAGEMENT OF ENDOMETRIOSIS OF THE LARGE INTESTINE
Author(s) -
Fleming W. B.
Publication year - 1956
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1956.tb07181.x
Subject(s) - medicine , endometriosis , lesion , differential diagnosis , hysterectomy , carcinoma , disease , biopsy , surgery , general surgery , radiology , gynecology , pathology
Summary 1. The current knowledge of endometriosis of the large bowel is reviewed, emphasizing the features assisting the differential diagnosis between this disease and carcinoma. 2. Attention is drawn to two ways in which endometriosis might involve the bowel: (a) as part of a generalized pelvic endometriosis when the diagnosis is often straightforward; (b)by producing a disc‐rete intestinal lesion when it is likely to be mistaken for carcinoma and extensive and unnecessary surgery undertaken to cure it. 3. This problem of diagnosis of the discrete lesion is illustrated by 5 case histories. 4. Endometriosis should be suspected if there is menstrual periodicity of symptoms. 5. It is shown that biopsy at operation of all apparent carcinomata of the colon in young women is justified to avoid errors in diagnosis. 6. In most patients it is found that pelvic endometriosis is extensive and requires treatment by hysterectomy and bilateral oophorectomy, irrespective of age. When the pelvic organs are intact it is believed an attempt should be made to conserve ovarian function in a young woman and to treat the lesion by resection. In older women one should avoid a dangerous resection and instead produce atrophy of the lesion by inducing an artificial menopause.