[Diagnosis and treatment of rectal and sigmoid endometriosis]

From October 1989 to September 1994 six resections of the bowel were performed for colorectal endometriosis. Five of, the patients, with a mean age of 32 years, presented clinical features. In all cases, colonoscopy showed a normal mucosa. All patients treated by hormonetherapy relapsed. The resection was segmental with immediate end-to-end anastomosis in 5 cases and partial in 1 case. In three cases, endometriosis of the genital tract was associated and treated during the initial laparotomy. One low rectosigmoid anastomosis fistulised. Rectosigmoid endometriosis accounts for 70% of bowel localisations and genital endometriosis is associated in 80% of cases. Deep and clinical rectosigmoid endometriosis does not respond to hormonetherapy and requires bowel resection. The pelvis should be explored and genital tract endometriosis treated. Postoperative hormonetherapy should be considered after initial surgery.