Rectal endometriosis causing colonic obstruction and concurrent endometriosis of the appendix: a case report

Katsikogiannis, Nikolaos; Tsaroucha, AK; Dimakis, K; Sivridis, E.; Ce, Simopoulos

doi:10.1186/1752-1947-5-320

Cited by 37 publications

(42 citation statements)

References 18 publications

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“…5 Other theories include vascular dissemination, colonic metaplasia and autoimmune disease. 6 Women with endometriosis may be asymptomatic, sub fertile, or suffer varying degrees of pelvic pain. The classic triad of dysmenorrhea, dyspareunia and infertility is characteristic of the disease.…”

Section: Discussionmentioning

confidence: 99%

Intestinal endometriosis: a diagnostic dilemma

Juneja¹,

Virk²,

Singla³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Endometriosis is a benign gynaecological condition that causes significant morbidity to women of reproductive age group. It uncommonly affects the gastrointestinal tract and acute bowel obstruction is a rare manifestation.Methods: A retrospective observational study was conducted on eight patients.Results: In three patients (37.5%), small intestinal involvement was seen, and colon was involved in five patients (62.5%). One (12.5%) patient presented with complete bowel obstruction while in others partial obstruction of the intestine was seen.Conclusions: Intestinal endometriosis is a diagnostic challenge and should be considered in young menstruating women with gastrointestinal symptoms. Intestinal endometriosis is the most common extra-pelvic site and it is found in 12% of women with endometriosis. The true incidence of endometriosis causing bowel obstruction is unknown. Pre or intraoperative sigmoidoscopy may prove helpful in ruling out malignancy. The gold standard for diagnosis is laparoscopy and biopsy, which allows a full assessment of the pelvis as well as surgical resection if required. The management of endometriosis is an integrated approach of both medical and surgical therapy. Bowel resection is usually undertaken if there are features of obstruction or bleeding, and if there is suspicion of malignancy.

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Section: Discussionmentioning

confidence: 99%

Intestinal endometriosis: a diagnostic dilemma

Juneja¹,

Virk²,

Singla³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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“…A PubMed adatbázisban és az interneten azóta 16, akut műtétet igénylő, vastagbél-ileust okozó endometriosisról találtunk angol nyelvű közleményt [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Figyelemre méltó, hogy ezek közül 13 az utóbbi 6 évben jelent meg.…”

Section: Eredeti Közleményunclassified

Belet infiltráló endometriosis: a gasztroenterológia és a sebészet új kihívása? Vastagbélileust okozó endometriosis három esete és irodalmi áttekintés

et al. 2016

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Bevezetés: Az endometriosis miatt kezelt betegek száma az utóbbi évtizedekben nőtt és az esetek is előrehaladottab-bak. A belet infiltráló endometriosis legsúlyosabb szövődménye a vastagbélileus. A betegség ezen szövődményéről napjainkig 16 angol nyelvű, a betegek anamnézisét, kivizsgálását leíró esetismertetés jelent meg. Betegek: 2009 óta az I. Nőgyógyászati Klinikán endometriosissal kezelt 535 beteg közül három esetében korábban vastagbél-elzáródás miatt akut sebészeti beavatkozás történt. Eredmények: A betegek (13/21) 59%-ának anamnézisében endometriosisra utaló tünetek vagy endometriosis miatti korábbi kezelés szerepelt. A képalkotó vizsgálatok (ultrahangvizsgálat, komputertomográfia, mágneses rezonanciás vizsgálat) csak egy esetben vetették fel endometriosis gyanúját. Az esetek 61%-ában (13/21) a primer műtét előtt, 24%-ában (5/21) a műtét után történt kolonoszkópia, de egyetlen esetben sem merült fel endometriosis lehetősége. Bár minden esetben ileus alakult ki, a mucosa csupán 5%-ban (1/19) volt infiltrált. Következtetések: Fiatal nőbeteg ileusa hátterében endometriosis is állhat. A másodlagos kolonoszkópos jelek (falmerevség, megtöretés, benyomat) felismerésével a gasztroenterológus segítheti a preoperatív diagnózist, így megelőzhető a műtét felesleges kiterjesztése. Javasolt nőgyógyász bevonása a műtétbe. Orv. Hetil., 2016Hetil., , 157(49), 1960Hetil., -1966 Kulcsszavak: endometriosis, vastagbélileus, kivizsgálás, kolonoszkópia, műtét Bowel endometriosis: new challenge for gastroenterology and surgery? Three cases of endometriosis caused large bowel ileus and review of the literatureIntroduction: A number of the patients suffer from endometriosis increased in the past decades and the cases have became more serious. The most critical complication of bowel endometriosis is the large bowel obstruction. Up to recently, 16 similar case reports of large bowel endomteriosis causing obstruction, with detailed medical history have been published in the literature in English language. Patients: Since 2007 535 female have been treated in the 1st Gynaecological Department with endometriosis, out of them three patients from emergency surgery in the history because of large bowel obstruction. Results: Symptoms suggesting endometriosis or previous intervention due to endometriosis were detected in 59% (13/21) of the cases. Preoperative ultrasound, computertomography, magnetic resonance imaging did not give correct diagnosis. Colonoscopy was carried out before the primary operation in 61% (13/21) and after the surgery in 24% (5/21) of the cases, but none of them confirmed endometriosis. Although all the patients developed obstruction, only in 5% (1/19) of the patients was the mucosa infiltrated by the endometriosis. Conclusions: In a young female patient, intestinal obstruction can be caused by bowel endometriosis. Identification of colonoscopic signs (rigidity, impression, kinking) of endometriosis may help to avoid unnecessary extension of intestinal resection. Gynaecologists should take part in the operations.

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“…4 In rare cases, secondary mucosal changes can mimic inflammatory bowel disease, ischaemic colitis or malignancy. 5,6 Large bowel obstruction as a consequence of endometriosis is sparsely described in the existing literature; 7,8 it is known that malignancy, followed by diverticular disease and volvulus are the most common causes. In the emergency setting in a young fit patient, acute large bowel obstruction is best managed by resection, on-table lavage and colonic anastomosis with or without ileostomy.…”

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confidence: 99%