Rare Case of Ileocecal Obstruction Secondary to Endometriosis Presenting for the First Time

Abstract

Though endometriosis involving the intestines is well known, it causing ileocecal obstruction is a rare presentation. Etiology for ileocecal obstruction may not be known in all the cases preoperatively and may sometimes need resection and histopathology for diagnosis. Here we present a case of endometriosis presenting for the first time as an ileocecal obstruction in a 39-year-old lady who presented to us with complaints of intermittent abdominal pain. Contrast CT scan of the abdomen showed terminal ileal stricture and wall thickening. She underwent diagnostic laparoscopy, which showed dilated distal small bowel loops with suspicious stricturing growth at the terminal ileum and ileocecal valve region. A formal laparoscopic right hemicolectomy was done and post-operative histopathology revealed endometriosis with fibrosis, causing a luminal obstruction. In conclusion, endometriosis should be considered as a rare differential in patients presenting with ileocecal obstruction and having inconclusive features on imaging, endoscopic or biopsy, especially in women of childbearing age.

Diagnosis and management of small bowel obstruction in the ileum caused by endometriosis: A case report

“…Symptoms of endometriosis are often nonspecific, such as dysmenorrhea and dyspareunia. More specific symptoms of bowel involvement can include constipation, diarrhea, dyschezia, and bowel obstruction but these can lead to misdiagnosis because they can be mistaken for Crohn's disease, irritable bowel syndrome, and malignancy [ 7 ]. While symptoms can be an indication, many women remain asymptomatic, presenting only as endometriosis progresses and involves more bowel.…”

Endometriosis as an Uncommon Cause of Intestinal Obstruction—A Comprehensive Literature Review

“…The mean age of patients diagnosed with ileocecal occlusions (15 cases) [74][75][76][77][78][79][80][81][82][83][84][85][86][87][88] was 37.86, with a minimum of 32 and a maximum of 46. Ileocecal occlusions were initially managed conservatively in four instances, two of which were followed by two laparoscopic procedures.…”