Rectosigmoid endometriosis: Diagnostic pitfalls and management – A case report

Abstract

Endometriosis constitutes a benign condition, occurring in 10%–12% of menstruating women. Bowel involvement is estimated to occur in 5%–12% with the rectosigmoid region involved in up to 90% of these cases. We present the case of a 45‐year‐old Caucasian female patient with rectosigmoid endometriosis.

Correlation of Endoscopic Findings with Suspected Intestinal Endometriosis in the Distal Sigmoid and Rectum as Observed on Transrectal Ultrasonography

“…The differential diagnoses of abdominal or chronic pelvic pain include diseases such as irritable bowel syndrome, inflammatory bowel disease, abdominal tumors, and intestinal endometriosis. 1 2 3 Currently, there is no endoscopic definition regarding intestinal involvement in endometriosis (EDT), which may lead to failure or delay in diagnosis. Endometriosis is a benign gynecological disease, defined by the presence of tissue similar to that of the endometrium, glands, and/or stroma that is located outside the uterine cavity and responsive to hormonal stimuli.…”

“…However, few studies to date have described these changes or an actual association with endometrial deposits located near or infiltrating the wall of the colon and rectum. 3 4…”

“…In cases of EDT that affects the intestinal segments, the sites with the highest incidence rates are the rectum and the distal sigmoid, accounting for up to 95% of intestinal implants. 3 13 14 15…”

“…The differential diagnoses of abdominal or chronic pelvic pain include diseases such as irritable bowel syndrome, inflammatory bowel disease, abdominal tumors, and intestinal endometriosis. [1][2][3] Currently, there is no endoscopic definition regarding intestinal involvement in endometriosis (EDT), which may lead to failure or delay in diagnosis.…”

“…However, few studies to date have described these changes or an actual association with endometrial deposits located near or infiltrating the wall of the colon and rectum. 3,4 The appearance and maintenance of endometrial deposits are dependent on hormonal stimulation. Therefore, the incidence of the disease is higher in reproductive-age women and does not commonly occur before menarche, or in postmenopausal women who are not exposed to estrogen replacement therapy.…”