Transrectal ultrasound-Techniques and outcomes in the management of intestinal endometriosis

The widespread use of endoscopic ultrasound has facilitated the evaluation of subepithelial and surrounding lesions of thegastrointestinal tract. Deep pelvic endometriosis, with or without infiltration of the intestinal wall, is a frequent disease that can be observed in women in their fertile age. Patients of this disease may present nonspecific signs and symptoms or be completelyasymptomatic. Laparoscopic surgical resection of endometriotic lesions is the treatment of choice in symptomatic patients. Anaccurate preoperative evaluation is indispensable for therapeutic decisions mainly in the suspicion of intestinal wall and/orurinary tract infiltration, and also in cases where we need to establish histological diagnosis or to rule out malignant disease.Diagnostic tools, including transrectal ultrasound, magnetic resonance image, transvaginal ultrasound, barium enema, andcolonoscopy, play significant roles in determining the presence, depth, histology, and other relevant data about the extensionof the disease. Diagnostic algorithm depends on the clinical presentation, the expertise of the medical team, and the technologyavailable at each institution. This article reviews and discusses relevant clinical points in endometriosis, including techniquesand outcomes of the study of the disease through transrectal ultrasound and fine-needle aspiration.