Endometriosis within the sigmoid colon/extragenital endometriosis

Abstract

Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity. Although it is common in women in the reproductive age, intestinal endometriosis is extremely rare and may lead to serious clinical problems. In this article, we present two rare cases of endometriosis localized in the sigmoid colon lumen. The first case is a 45 year-old female complaining of rectal bleeding for 6 months. A polypoid lesion with suspicion of malignancy, 3-4 cm in size was identified at colonoscopy. Laparoscopic anterior resection was performed since it was not suitable for colonoscopic polypectomy. The pathology examination revealed extragenital endometriosis. The second case is a 36 year-old female admitted for lower abdominal pain and rectal bleeding for the last 3 months. She was diagnosed with sigmoid diverticulitis. The patient's symptoms regressed with medical treatment, but due to early and multiple recurrent episodes it was decided to perform an elective laparoscopic anterior resection. The pathology report stated diverticulosis coli and intraluminal endometriosis. Intestinal endometriosis should be considered as part of the differential diagnosis in female patients of the reproductive age who present with constipation, gastrointestinal bleeding, nausea, vomiting, cramp-like abdominal pain, diarrhea and pelvic pain. In these patients, resection and anastomosis of the effected bowel segment is accepted as the choice of treatment.

Laparoscopic resection of giant endometriotic cysts with mesenteric implantation

“…3 Symptomatology in patients with involvement of the digestive tract is usually the same as that observed in patients with genital endometriosis, however, specific symptoms of the digestive tract are observed, such as rectal pain with perineal irradiation, changes in depositional rhythm, diarrhea and constipation, rectal bleeding which coincides with menstruation, abdominal distension and acute intestinal obstruction in advanced stages. 4 A multidisciplinary approach, involving surgical and medical management, should be proposed to the patients that present this pathology; the strategy to follow will depend on the patient's clinical presentation and fertility desires. Medical treatment is reserved for cases of satisfied maternity and when there are no serious complications secondary to the disease.…”

“…It has a reported prevalence of 8-10% in women of reproductive age, 5-10% in women with chronic pelvic pain and 20-40% in patients with a history of infertility; this condition represents one of the main causes of hysterectomy and public health costs of up to 69. 4…”

A case report: Rectal endometriosis mimicking rectal cancer

“…Endometriosis is a chronic and benign gynecologic disease, with endometrial glands and stroma presenting outside the uterine cavity [ 1 , 2 ]. Endometriosis affects approximately 3%–15% of childbearing age women [ 1 , 3 , 4 ]. Endometrial tissue can present anywhere of a woman body and can be divided into intra-peritoneal and extra-peritoneal endometriosis according to the anatomic location.…”

Endometriosis en colon sigmoides asociada a hematoquecia en una paciente histerectomizada

“…La endometriosis extrapélvica puede involucrar a cualquier órgano. Sin embargo, su situación más frecuente es en el intestino, pero solamente 10 a 15% afecta al recto sigmoides (3) . Las implantaciones endometrió-sicas son el tipo de lesión más común y suelen afectar a la capa serosa del intestino, pero puede penetrar también a la mucosa, denominán-dose endometriosis profunda infiltrante (4) .…”