Endometriosis, defined as the presence of functional endometrial glands and stroma outside the uterine cavity, is a common condition with an estimated prevalence of 10-15%. Deeply infiltrating endometriosis (DIE) is characterised by endometriotic deposits infiltrating into the peritoneum to a depth of > 5mm. Approximately 3-37% women with DIE have bowel involvement, the rectosigmoid being the most common site of involvement. DIE can be associated with diarrhoea, rectal bleeding and non-cyclical pelvic pain. Accurate preoperative evaluation of the location and extent of the colonic lesions...

A retrospective review was performed of all patients who underwent pre-operative CT colonography for DIE between January 2014 and January 2016 in teritary referral centre for DIE. Clinical, radiological and intraoperative data were recorded. Patient selection: All potential surgical candidates were discussed in MDT meeting with consultant radiologist with subspecialist interest in gynaecological imaging, consultant gynaecologist and consultant colorectal surgeon. Patients were referred for CT colonography if high clinical and radiological suspicion of DIE from prior pre-operative imaging. CT colonography: CT colonography is a reliatively...

32 patients were clinically diagnosed with DIE with 15 patients referred for surgery. Pre-operative CT colonography was performed in all surgical candidates (46.8% of total patient cohort). Sigmoid/rectosigmoid involvement was suspected in 10 preoperative patients (66.7%). 13/15 (86.7%) patients required adhesionlysis/colonic resection for sigmoid/rectosigmoid involvement, thus CT colonography demonstrating Specificity: 69.2%; Sensitivity: 50% and Positive Predictive Value: 90%.

Our study was limited due to small sample size, however it mirrored findings of other studies demonstrating CT colonography has a high positive predictive value (PPV) in detecting colonic involvement in DIE, however it lacks sensitivity and specificity for extent of disease and is not predictive for type of colonic surgery.

Elisabeth O'Dwyer 4th Year Resident Department of Radiology Tallaght University Hospital, Ireland [email protected]

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