What is the role of radiography in the workup of endometrioma/endometriosis?

Updated: Dec 14, 2018
  • Author: Shawn Daly, MD; Chief Editor: Eugene C Lin, MD  more...
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Plain film radiographs are not indicated in the radiologic workup of endometriosis. No specific findings are found on plain films. [14] The findings on contrast studies (a barium enema and an intravenous [IV] urogram) are nonspecific.

Uncommonly, women with rectal pain or bleeding from endometriosis involvement of the bowel may undergo a barium enema examination. A tethered submucosal mass that is centered at the anterior midrectum—representing cul-de-sac implants involving the rectal wall—is typical. [14]

An IV urogram in patients with endometriosis may show ureteral obstruction at or below the pelvic brim. [15] This obstruction may be from an endometriosis implant invasion into the ureter or from a mass effect from endometrioma.

The appearance of endometriosis on a barium enema contrast study can be mimicked by rectal carcinoma or serosal metastases.

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