Rectal obstruction due to endometriosis

Abstract

Although endometriosis is a disorder commonly found in reproductive-age women, it does not involve the bowel very often. The circumferential involvement of the rectum is rare and the obstructive symptoms can be difficult to differentiate from those of inflammatory or malignant diseases. We report two patients with rectal endometriosis whose first prominent symptoms were those of intestinal obstruction. A 26-year-old woman was admitted with obstructive symptoms. In order to alleviate the obstruction and extend the preoperative evaluation, a decompressive colostomy was done. The diagnosis of endometriosis was made by laparoscopy and biopsies of the thickened cul-de-sac peritoneum. Another woman, 40 years of age, was referred to us with a colostomy. She had undergone a laparotomy due to an obstructive acute abdomen a year before, and a frozen pelvis was found. Biopsy specimens had been collected and the pathological report revealed endometrioma. A rectosigmoidectomy, encompassing the stenotic rectal segment, was done along with primary anastomosis. The pathological examination confirmed rectal endometriosis. The conclusion is that, although rare, rectal endometriosis can cause significant stenosis of the organ, leading to obstructive symptoms. Despite its low frequency, it should always be considered in the differential diagnosis of rectal stenosis involving women of childbearing age.

Ascites and Ileus due to Endometriosis

“…6 -10 There have been numerous reports and case series of ileus or bowel obstruction due to endometriosis. [11][12][13][14][15][16][17][18][19][20][21] These cases typically describe a localized obstructive lesion that is identified and resected. Confirming this pattern, Yantiss and colleagues reviewed 44 case reports of intestinal endometriosis, of whom 15 presented with abdominal pain and 8 with obstruction.…”

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

“…It is known that the occurrence of endometriosis in the general female population is lower than in that of reproductive age, while the occurrence in endopelvic and gastrointestinal locations is at 5-15% of patients of reproductive age [5,6,16,17]. Gastrointestinal endometriosis (3-37% of an ectopic location) may affect the ileum, appendix, sigmoid colon and rectum [6] with a more frequent location in the rectosigmoid (50-90%).…”

“…Endometriosis occurs in 3-10% of the general female population of reproductive age, 40-80% present symptoms such as pelvic pain, infertility, or both [2,3]. Endometriosis rarely involves the small intestine, the appendix, the colon, the lung or other tissues [4,5]. …”

“…Circumferential endometriosis of the rectum should be differentially diagnosed from inflammatory or malignant diseases [5]. Endometriosis of the appendix usually presents with abdominal pain [8].…”

Endometriotic Rectosigmoid Obstruction Presenting With a Frozen Pelvis-Mimicking Carcinoma

“…4,5 However, there is only 1 recent report of colorectal endometrioma causing a frozen pelvis. 6 We report a case of rectal endometrioma diagnosed to have malignancy by imaging, found to have a frozen pelvis on laparotomy and was subjected to chemotherapy and radiotherapy before resection.…”