Missed diagnosis and misdiagnosis in patients with rectal endometriosis: an analysis of 12 cases        GE Xin*, WANG Xi-shan. *Department of Colorectal Surgery, the Third Hospital of Harbin Medical University, Haerbin 150081, China
Corresponding author：WANG Xi-shan, E-mail: wxshan1208@yahoo.com.cn
Abstract   Objective   To explore the reasons of missed diagnosis and misdiagnosis in patients with rectal endometriosis. Methods    The clinical data of 12 cases of missed diagnosis and misdiagnosis among all 13 cases with rectal endometriosis admitted between January 1980 and December 2009  in the Department of Colorectal Surgery, the Third Hospital of Harbin Medical University were analyzed retrospectively. Results    Only one (7.7%) of 13 cases was diagnosed correctly before surgery. Among other 12 cases, 3 (23.1%) cases were misdiagnosed. Abdominal or pelvic pain was the most regullar symptom, which was occurred in 9 cases. Two cases showed hematochezia during menstrual period. Four (57.1%) in 7 cases of gyneclogical examinations were touched nodules in Douglas’ pouch. While 3 (75.0%) in 4 cases of anal examinations had positive founding. All 12 cases were received surgery including 8 cases of segment intestinal excision and 4 cases of rectal anterior wall excision only. Conclusion    Rectal endometriosis is difficult to be diagnosed before operation. Imaging techniques are mandatory and surgery is the first choice for treatment.