Endometriosis is typically marked by the implantation and proliferation of foci of endometrial stroma and glands outside the endometrial cavity and uterine musculature. Extra-gonadal seeding has been observed in sites like the small and large bowel, peritoneum, appendix, pleura, umbilicus, old wound scars, subarachnoid space, inguinal canal, heart and lungs.14,7 The gastrointestinal tract is the third most common localization of endometriosis after the ovaries and the peritoneum, with intestinal involvement being reported in about 12 to 37% of individuals.1,2,5-7 Establishing a diagnosis of intestinal endometriosis can often be a diagnostic challenge. We present an interesting case of sigmoidal endometriosis in a 46-year-old female, whose initial presentation was irregular bowel movements with rectal bleeding.
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