Colonic Endometriosis: Dig Deeper for Diagnosis

Badipatla, Kanthi Rekha; Vupputuri, Anisha; Niazi, Masooma; Blaise, Marie-Nirva; Nayudu, Suresh Kumar

doi:10.14740/gr760e

Cited by 4 publications

(8 citation statements)

References 16 publications

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“…Mobile cecum is evident in 10–20% of the population with several cases of concurrent cecal volvulus and appendicitis [ 3 , 4 ]. This may be overlooked as the presentation mimics other gastrointestinal diseases as noted in our patient with an initial diagnosis of irritable bowel syndrome [ 7 ]. The differential diagnosis for irritable bowel syndrome is very broad we illustrate the most common ones in Table 2 with clinical findings of our patient highlighter in blue.…”

Section: Discussionmentioning

confidence: 99%

“…Intestinal involvement with endometriosis can occur in 3–37% patients usually involving the serosa and muscularis propria, but rarely can involve the mucosa as well [ 6 , 7 , 10 ]. Therefore, depending on the layer of the gut mucosal involvement, the clinical presentation varies and histopathological diagnosis is considered the confirmatory diagnostic test [ 7 ]. In our patient despite having intermittent abdominal symptoms for many years, endometriosis was not considered as a differential as her symptoms did not correlate with her menstrual cycles.…”

Section: Discussionmentioning

confidence: 99%

“…Volvulus and appendicitis can also be seen in patients with endometriosis as it most commonly involves the rectum, sigmoid colon, and appendix [6,10]. These patients can be asymptomatic or have alterations in bowel habits, dyschezia, and hematochezia in a cyclical pattern [6][7][8]. Intestinal involvement with endometriosis can occur in 3-37% patients usually involving the serosa and muscularis propria, but rarely can involve the mucosa as well [6,7,10].…”

Section: Discussionmentioning

confidence: 99%

“…Endometriosis occurs when there is extra-uterine implantation of the inner layer of the uterus or the endometrial tissue, and presents with a wide variety of symptoms depending on the location of the implant [ 6 , 7 ]. This condition is usually seen in reproductive females and can be complicated with obstruction of the bowel due to gut involvement.…”

Section: Introductionmentioning

confidence: 99%

“…This condition is usually seen in reproductive females and can be complicated with obstruction of the bowel due to gut involvement. This diagnosis may be overlooked as it may mimic other common gastrointestinal disorders such as irritable bowel syndrome, inflammatory bowel disease, appendicitis, or malignancy [7,8]. Therefore, it also requires pathological confirmation for diagnosis and treatment to prevent further symptoms [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Abdominal pain – a common presentation with unusual diagnosis: a case report

Kumaran¹,

Vanka²,

Rab³

et al. 2020

Journal of Community Hospital Internal Medicine Perspectives

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Acute abdominal pain is a frequent cause for evaluation in the clinic and emergency room. A number of causes of abdominal pain are diagnosed easily based on the history, physical exam, and some laboratory findings. However, unusual conditions may pose a challenge and require invasive procedures for diagnosis. Rare anomalies such as mobile caecum may present as either typical or atypical acute appendicitis. Endometriosis and pinworm infections can also present as acute appendicitis but are uncommon presentations. To increase the awareness of these uncommon causes of appendicitis, we present a 32 year old female who was previously diagnosed with irritable bowel syndrome later found to have all of the above mentioned rare conditions contributing to abdominal pain. She presented to the emergency room with a one day history of acute right lower quadrant abdominal pain along with nausea and non-bilious vomiting. Physical exam revealed right lower quadrant tenderness to palpation. A computerised tomography of the abdomen and pelvis demonstrated a mobile cecum in the left abdomen. She subsequently underwent a diagnostic laparotomy with cecopexy and appendectomy. Pathology of the appendix showed findings suggestive of endometriosis and intraluminal enterobius vermicularis. She was treated with two doses of pyrantel pamoate for the parasitic infection, and subsequently had resolution of her symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Abdominal pain – a common presentation with unusual diagnosis: a case report

Kumaran¹,

Vanka²,

Rab³

et al. 2020

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

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A Comparative Study of Endometriosis and Normal Endometrium Based on Ultrasound Observation

Lin

Wang

Zhu

2022

Applied Bionics and Biomechanics

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In order to compare the microscopic ultrastructure of eutopic endometrium and normal endometrium in patients with endometriosis, to study the specific pathogenesis of endometriosis. In this paper, on the basis of using B-ultrasound technology, several patients with endometriosis were subjected to B-ultrasound to observe the ultrastructure of the eutopic uterine endometrium and compared with the pictures of normal endometrium to carry out the specific analysis between the two ultrastructural comparisons. This study is based on the analysis of B-ultrasound images of patients with endometriosis, compares the difference between their ultrastructure and normal human body, and conducts specific pathological diagnosis and analysis to find out the impact of the endometrium in place. The specific factors of the occurrence of lesions and the corresponding treatment methods are proposed. The experimental results show that the ultrastructure of endometriosis eutopic endometrium is different from that of normal endometrium. The microvilli of secretory cells and the cilia of ciliated cells of the former are abnormally increased and lengthened, and they are superior to B-ultrasound technology. The success rate of the examination is 93.75%, which can play an important role in the specific examination process of patients with endometriosis, as one of the actual indicators of detection. Under the electron microscope, microvilli are tiny finger-like protrusions extending from the cell membrane and the cytoplasm on the free surface of the cell, surrounded by the cell membrane and perpendicular to the cell membrane surface.

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Diet associations in endometriosis: a critical narrative assessment with special reference to gluten

Brouns,

Van Haaps,

Keszthelyi

et al. 2023

Front. Nutr.

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Endometriosis is characterized by the presence of endometrium-like tissue outside the uterus. The etiology remains largely unknown. Despite adequate treatment, patients can still experience symptoms or side effects resulting in therapy incompliance and in self-management strategies such as dietary measures is increasing. A gluten free diet is thought to be contributory in reducing endometriosis-related pain, thereby optimizing quality of life. However, data is conflicting and currently provides no evidence for causality. This narrative review aims to put the effect of dietary self-management strategies on endometriosis in a balanced perspective, especially the effect of gluten and a gluten free diet. Several studies have found a strong overlap in symptoms, metabolic and immune responses associated with endometriosis and those associated with celiac disease, ulcerative colitis, Crohn’s disease, irritable bowel syndrome and non-celiac wheat sensitivity. However, it remains unclear whether these diseases and/or disorders are causal to an increased risk of endometriosis. Some studies have found a positive effect on the risk of endometriosis, endometriosis-related symptoms and quality of life (QoL) when women either avoided certain nutrients or foods, or applied a specific nutrient supplementation. This includes the avoidance of red meat and omega-3, an increasing intake of foods rich in anti-oxidants, micronutrients and dietary fibers (e.g., fruit, vegetables) and the appliance of a gluten free diet. However, data from the available studies were generally graded of low quality and it was noted that placebo and/or nocebo effects influenced the reported positive effects. In addition, such effects were no longer seen when adjusting for confounders such as overweight, when a translation was made from in vitro to in vivo, or when the nutrients were not supplemented as isolated sources but as part of a mixed daily diet. Finally, some studies showed that long-term adherence to a gluten free diet is often associated with an impaired diet quality and nutrient intake, leading to negative health outcomes and reduced QoL. Concluding, scientific evidence on the efficacy of dietary interventions on well-defined clinical endpoints of endometriosis is lacking and recommending a gluten free diet to women solely diagnosed with endometriosis should therefore not be advised.

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Colonic Endometriosis: Dig Deeper for Diagnosis

Cited by 4 publications

References 16 publications

Abdominal pain – a common presentation with unusual diagnosis: a case report

Abdominal pain – a common presentation with unusual diagnosis: a case report

A Comparative Study of Endometriosis and Normal Endometrium Based on Ultrasound Observation

Diet associations in endometriosis: a critical narrative assessment with special reference to gluten

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