E-ISSN: 2619-9467

Contents    Cover    Publication Date: 22 Mar 2022
Year 2022 - Volume 32 - Issue 1

Open Access

Peer Reviewed

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A Rare Cause of Bowel Obstruction Mimicking Colon Cancer: Endometriosis

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JCOG. 2022;32(1):27-31
DOI: 10.5336/jcog.2021-85436
Article Language: EN
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Intestinal involvement is observed in a significant portion of patients diagnosed with endometriosis. Involvement is often on the serosal surface of the sigmoid colon. Rarely, it takes place in the colonic mucosa and lymph nodes, causing lumen obstruction. Colonoscopic biopsies may be insufficient in the differential diagnosis of malignancy and diverticulitis. We report a case of a 41-year-old premenopausal female patient with endometriosis located in the ampulla recti causing complete intestinal obstruction. Although having a significant rectal mucosal mass, the diagnosis could not be made with tissue samples taken by endoscopy. During the examination, the patient developed ileus. With the preliminary diagnosis of rectal cancer, surgical intervention was applied with oncological principles, and its treatment was performed with opening a diverting ileostomy. Diagnosis of rectosigmoid endometriosis is difficult. In women of childbearing age, rectosigmoid endometriosis should be kept in mind in lower gastrointestinal tract obstructions.
  1. Shafrir AL, Farland LV, Shah DK, Harris HR, Kvaskoff M, Zondervan K, et al. Risk for and consequences of endometriosis: a critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol. 2018;51:1-15. [Crossref]  [PubMed] 
  2. Vercellini P, Viganò P, Somigliana E, Fedele L. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol. 2014;10(5):261-75. [Crossref]  [PubMed] 
  3. De Cicco C, Corona R, Schonman R, Mailova K, Ussia A, Koninckx Pr. Bowel resection for deep endometriosis: a systematic review. BJOG. 2011;118(3):285-91. [Crossref]  [PubMed] 
  4. Meuleman C, Tomassetti C, D'Hoore A, van Cleynenbreugel BV, Penninckx F, Vergote I, et al. Surgical treatment of deeply infiltrating endometriosis with colorectal involvement. Hum Reprod Update. 2011;17(3):311-26. [Crossref]  [PubMed] 
  5. Johnson NP, Hummelshoj L, Adamson GD, Keckstein J, Taylor HS, Abrao MS, et al. World Endometriosis Society consensus on the classification of endometriosis. Hum Reprod. 2017;32(2):315-24. [Crossref]  [PubMed] 
  6. Becker CM, Gattrell WT, Gude K, Singh SS. Reevaluating response and failure of medical treatment of endometriosis: a systematic review. Fertil Steril. 2017;108(1):125-36. [Crossref]  [PubMed]  [PMC] 
  7. Nezhat C, Li A, Falik R, Copeland D, Razavi G, Shakib A, et al. Bowel endometriosis: diagnosis and management. Am J Obstet Gynecol. 2018;218(6):549-62. [Crossref]  [PubMed] 
  8. Vercellini P, Sergenti G, Buggio L, Frattaruolo MP, Dridi D, Berlanda N. Advances in the medical management of bowel endometriosis. Best Pract Res Clin Obstet Gynaecol. 2021;71:78-99. [Crossref]  [PubMed] 
  9. Ono H, Honda S, Danjo Y, Nakamura K, Okabe M, Kimura T, et al. Rectal obstruction due to endometriosis: a case report and review of the Japanese literature. Int J Surg Case Rep. 2014;5(11):845-8. [Crossref]  [PubMed]  [PMC] 
  10. Lenz J, Fiala L, Chvatal R, Tibon J, Uncapher L, Kavka M, et al. Rectal perforation caused by deep infiltrating endometriosis in non-pregnant woman: case report and short review of the literature. Ann Ital Chir. 2019;8:S2239253X19029360. [PubMed] 
  11. Rana R, Sharma S, Narula H, Madhok M. A case of recto-sigmoid endometriosis mimicking carcinoma. Springerplus. 2016;5:643. [Crossref]  [PubMed]  [PMC] 
  12. Roman H, Milles M, Vassilieff M, Resch B, Tuech JJ, Huet E, et al. Long-term functional outcomes following colorectal resection versus shaving for rectal endometriosis. Am J Obstet Gynecol. 2016;215(6):762.e1-9. [Crossref]  [PubMed] 
  13. Vlek SL, Lier MCI, Koedam TWA, Melgers I, Dekker JJML, Bonjer JH, et al. Transanal minimally invasive rectal resection for deep endometriosis: a promising technique. Colorectal Dis. 2017;19(6):576-81. [Crossref]  [PubMed] 
  14. Kazama S, Hiramatsu T, Kuroda K, Hongo K, Watanabe Y, Tanaka T, et al. A case of unique endoscopic findings of intestinal endometriosis exposed to the mucosa: aggregation of papillary protruded bulges from the submucosal elevation of the rectum. Clin J Gastroenterol. 2019;12(2):166-70. [Crossref]  [PubMed] 
  15. Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020;382(13):1244-56. [Crossref]  [PubMed]