Clinical Cases and Videos

  • Mauricio León
  • Hugo Sovino
  • Juan Luis Alcazar


The diagnosis of deep endometriosis (DE) using transvaginal ultrasound (TVS) is an operator-dependent technique. For this method to be optimized, it must be done in a standardized way by an experienced operator. This standard approach in obtaining and analyzing the images has been recently published by a group of world experts, the International Deep Endometriosis Analysis (IDEA) group, and this consensus statement is reviewed in detail in Chap.  3 [1].

Supplementary material

Video 17.1

Complete septate uterus, rectovaginal nodule with involvement of vaginal posterior wall, uterosacral ligaments, and anterior rectum wall (diabolo-like nodule) (MOV 56093 kb)

Video 17.2

Presence of negative sliding sign in the anterior compartment (obliteration of uterovesical region). Also can be observed a uterovesical region nodule of 12 × 10 × 12 mm. In the posterior compartment, it is possible to observe a nodule of 16 × 9 × 12 mm with involvement of left uterosacral ligament insertion (MOV 88035 kb)

Video 17.3

Presence of fixed ovaries, right atypical endometrioma with solid component without vascularization. Corpus luteum in the left ovary and presence of two anterior rectal wall nodules of 12 × 11 × 8 mm and 13 × 7 × 9 mm, respectively (multifocal lesions). Also, it can be observed another lesion of 14 × 10 × 11 mm in between both rectal lesions. Negative sliding sign in the posterior compartment (MOV 67710 kb)

Video 17.4

Multifocal compromise of rectosigmoid with anterior rectal wall nodules with complete septate uterus. In addition, you can observe another lesion with compromise of the left uterosacral ligament and posterior vaginal wall (MOV 72082 kb)

Video 17.5

The measurement of anterior rectal wall nodule was 22 × 9 × 14 mm, without involvement of submucosa. Another lesion of 14 × 9 × 10 mm, fixed to the previous one, involving the uterosacral ligaments was found (MOV 29214 kb)

Video 17.6

Bladder dome nodule of 10 × 7 × 10 mm. Ureteral intravesical segment nodule (extrinsic compromise) of 18 × 9 × 10 mm (MOV 54355 kb)

Video 17.7

Bladder base intramural nodule of 19 × 20 × 21 mm, without compromise of intravesical ureters. Also can be observed a right uterosacral ligament nodule of 9 × 6 × 7 mm, fixed to the posterior vaginal wall (MOV 42757 kb)

Video 17.8

A rectosigmoid anterior rectal wall nodule of 43 × 13 × 14 mm with involvement of vagina and uterosacral ligament. In addition, you can observe another lesion of 16 × 16 × 11 mm (MOV 54452 kb)

Video 17.9

At seven centimeters from the anal verge, it can be seen a rectosigmoid anterior rectal wall nodule with involvement of vagina and uterosacral ligaments of 42 × 7 × 19 mm. Also you can observe vaginal lesion of 17 × 8 × 12 mm (MOV 31560 kb)

Video 17.10

Retroverted uterus. A rectosigmoid anterior rectal wall nodule with transmural compromise with involvement of submucosa of 30 × 10 × 22 mm. It can be observed a lesion involving the uterosacral ligaments with superficial vaginal involvement (MOV 63761 kb)


  1. 1.
    Guerriero S, Condous G, van den Bosch T, Valentin L, Leone FP, Van Schoubroeck D, Exacoustos C, Installé AJ, Martins WP, Abrao MS, Hudelist G, Bazot M, Alcazar JL, Gonçalves MO, Pascual MA, Ajossa S, Savelli L, Dunham R, Reid S, Menakaya U, Bourne T, Ferrero S, Leon M, Bignardi T, Holland T, Jurkovic D, Benacerraf B, Osuga Y, Somigliana E, Timmerman D. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol. 2016;48(3):318–32. Epub 2016 Jun 28. PubMed PMID: 27349699.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mauricio León
    • 1
  • Hugo Sovino
    • 2
  • Juan Luis Alcazar
    • 3
  1. 1.Ultrasound Unit, Department of Gynaecology and ObstetricsClinica INDISASantiagoChile
  2. 2.Department of Obstetrics and Gynecology, Human Reproduction UnitClìnica INDISASantiagoChile
  3. 3.Department of Obstetrics and GynecologyClínica Universidad de Navarra School of Medicine, University of NavarraPamplonaSpain

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