Ileocecal endometriosis : clinical and pathogenetic implications of an underdiagnosed condition

Objective To review our experience with surgical treatment of ileocecal endometriosis. Design Observational study. Setting Tertiary university hospital in Italy. Patient(s) Eight consecutive patients with infiltrating ileocecal endometriosis operated on between 2003 and 2005. Intervention(s) All of the women underwent laparotomic ileocecal or cecal resection and had radical treatment of rectovaginal endometriosis as well. Main Outcome Measure(s) Long-term relief of pelvic pain, constipation, and dyschezia. Result(s) There were no postoperative intestinal complications. At a mean ± SD follow-up of 106 ± 10 months, all of the patients reported significant improvement of pelvic pain and bowel symptoms. Conclusion(s) Infiltrating ileocecal endometriosis requiring bowel resection was associated in all cases with infiltrating rectovaginal endometriosis, possibly reflecting a common pathogenesis. A thorough clinical evaluation of women with rectovaginal endometriosis might allow an improvement in the difficult preoperative diagnosis of ileocecal endometriosis. Our data support the long-term efficacy of the radical surgical resection of associated ileocecal and rectovaginal endometriotic lesions in reducing pelvic pain, constipation, and dyschezia.