Sonographic Differential Diagnosis in Deep Infiltrating Endometriosis: The Bowel
Table 2
Characteristics of all cases of Figure 2 at a glance.
Organ
Sonographic diagnosis
Differential diagnosis
Case number
US suspect
Appearance
US suspect
Differences
Sigma and ileum
#9, #10, and #11
Multifocal endometriosis of the sigma-rectum (confirmed diagnosis)
Typical appearance of endometriosis of the bowel
Rectal polyp (see case #18 of Figure 4) Rectal cancer (see cases #19 and #20 of Figure 4)
(i) Age (ii) Family history (iii) Rectal bleeding (iv) Recta polyps and cancer can be both multifocal, but they grow from inside outwards while endometriosis starts from the serosa and encroaches the bowel
#12
Endometriosis of the ileum (confirmed diagnosis)
The small bowel as seen in the vesico-uterine pouch and presented a typical endometriosis lesion (see cases #1 to #8)
Endometriosis of the vesico-uterine pouch
(i) Evidence of peristalsis (ii) Positive “sliding sign”