Published online Nov 16, 2014. doi: 10.4253/wjge.v6.i11.525
Revised: September 25, 2014
Accepted: October 28, 2014
Published online: November 16, 2014
Recto-sigmoid endoscopic ultrasonography (RS-EUS) has first been used in the staging of pelvic deep infiltrating endometriosis in the early 1990's. Since then, although publications have been sparse, RS-EUS is routinely used for this indication in few centers. In this paper, we focus on technical aspects and operating method of rectal and sigmoid endo-sonography, and describe the most characteristic echographic presentations of endometriosis of the lower digestive tract. Through a literature review, results obtained with different types of endo-rectal probes, either flexible endoscopic, or blind rigid, are presented and compared with those of other close imaging techniques: magnetic resonance imaging and the more recent trans-vaginal sonography. As well as these two latter techniques, RS-EUS appears as an interesting method in the staging of pelvic deep infiltrating endometriosis particularly to evaluate rectal and sigmoid infiltrations. However, more prospective studies are required, to correctly define respective indications for each exam, in the light of recent advancements in treating this frequent disease.
Core tip: Pelvic deep infiltrating endometriosis is a disabling disease of increasing rate. Today new medical and surgical therapies are proposed in the management of pain and infertility, and the choice of an optimal treatment strategy requires a precise anatomic evaluation. Several imaging techniques are available, either additive or competitive, in this staging. Rectosigmoid endoscopic-ultrasonography (RS-EUS), is routinely used in the field of gastroenterology, mostly for staging of rectal cancer. Few studies have demonstrated it could also be of interest to image endometriotic recto-sigmoid infiltrations. In this review, we tried to assess indications and results of RS-EUS, compared to those of magnetic resonance imaging and transvaginal sonography.