Rectal obstruction due to endometriosis: A case report and review of the Japanese literature

Abstract

INTRODUCTIONColorectal obstructive endometriosis is relatively rare in Japan and its differentiation from malignancy is often difficult. We report a case of rectal obstructive endometriosis.PRESENTATION OF CASEA 37-year-old woman was referred to our hospital with a suspected ileus. Her chief symptoms were left lower abdominal pain and vomiting. Colonoscopy showed an intraluminal mass of redness in the upper rectum. A proctectomy was performed because of the bowel obstruction. The rectum was filled with an intraluminal mass measuring 5 cm × 4 cm, and endometriosis was diagnosed pathologically.DISCUSSIONA preoperative diagnosis of colorectal obstructive endometriosis is often difficult because of the lack of definite diagnostic, clinical, sonographic, or radiological findings that are characteristic of this disease. Medical treatment is not always effective for colorectal obstructive endometriosis, and surgery is often performed.CONCLUSIONColorectal obstructive endometriosis should be considered as a differential diagnosis in cases of various gastrointestinal symptoms in women who are of reproductive age.

Bowel endometriosis treated with simultaneous ileocecal and rectal resection

“…As chronic inflammation occurs, dysmenorrhea, pelvic pain and infertility can develop [ 2 ]. Endometriosis is reported in 6–10% of women of reproductive age [ 1 ], with some reports as many as 15% [ 3 ]. Endometriosis is classified in three types: peritoneal endometriosis, endometriotic ovarian cysts and deeply infiltrative endometriosis (DE) [ 3 ].…”

“…By definition, DE is where lesions infiltrate beyond 5 mm from serosa into muscular layer within the peritoneum. About 10% of endometriosis occurs in the bowel, 80–90% of reported cases occur in rectum and sigmoid colon [ 1 , 3 ]. Clinical symptoms are pelvic pain, infertility, menstrual pain, constipation, diarrhea, tenesmus and rectal bleeding [ 3 ].…”

“…Differential diagnosis includes inflammatory bowel disease, solitary rectal ulcer syndrome and rectal tumor [ 3 ]. For diagnosis of endometriosis, presented symptoms and physical findings are most important, but transvaginal ultrasonography, barium enema examination and magnetic resonance imaging (MRI) are also useful [ 1 – 3 ]. In this case, from the characteristic symptoms, endometriosis was suspected in differential diagnosis.…”

“…Endometriosis is a disease where endometrial tissue presents outside of the endometrium or myometrium [ 1 ]. It occurs in ~6–10% of the females of reproductive age [ 1 ].…”

Arrays to detect Erring Factors of Endometrial Origin in Endometriosis

“…Since, endometriosis is known to be an extrauterine condition, the molecular profiling of the peritoneum may provide answers to a higher proportion of women developing peritoneal and ovarian endo metriosis 32 as opposed to the rare cases of thoracic endometriosis, 33 colorectal obstructive endometriosis, etc. 34 Results from their data demonstrated an upregulation of adhesion molecules and genes involved in inflammatory response implying the significance of these during the early stages of endometriosis progression. 35…”