Unusual case of acute large bowel obstruction: endometriosis mimicking sigmoid malignancy

Acute Large Bowel Obstruction due to Pelvic Endometriosis: A Case Report

“…Intestinal endometriosis is defined as one of the forms of deeply infiltrating endometriosis with the lesion invading at least the subserosal and the muscular layers of the bowel wall. 2 The bowel is the most common (3-12%) extragenital site of endometriosis 3 with a predominant occurrence in the rectosigmoid junction (50-90%), followed by the small bowel (2-16%), the appendix (3-18%), and the cecum (2-5%). Patients with IE may complain of cyclic pain as well as cyclic constipation, hematochezia, catamenial diarrhea, tenesmus, and pain in the lower abdomen.…”

“…5 In the adult population, IE is a clinical challenge because it can be mistaken for other acute obstructive diseases, such as colorectal carcinoma. 2 However, unlike in cases of colorectal carcinoma, intraluminal pathology in IE is typically not detected by means of a biopsy because IE rarely implants at the mucosal layer of the bowel. 3 Findings of CT of the abdomen and the pelvis, although useful in the diagnosis of LBO, are nonspecific for endometriosis-related abnormalities of…”

“…Many theories have been proposed to explain the ectopy of the functional endometrial tissue; these include retrograde menstruation, Mullerian metaplasia, and lymphovascular dissemination. 2 When endometriosis permeates deep into the pelvis, it can infiltrate the local bowel and cause acute or chronic gastrointestinal symptoms. This report presents a rare case of acute large bowel obstruction (LBO) due to intestinal endometriosis (IE) in a woman of reproductive age.…”

Rectal endometriosis mimicking primary rectal adenocarcinoma

“…22,23 Endometriosis can also mimic other types of malignant tumors including melanoma, urothelial carcinoma, and ovarian cancer. [24][25][26] The diagnostic challenges of in cytology specimen is well-known and has been described in many studies as well. 18,27,28 Endometriosis can be a precursor of other types of ovarian cancer, including endometrioid and clear cell ovarian cancers.…”

An unusual case of bowel obstruction secondary to endometriosis

“…It is the extra-uterine deposition of endometrial tissue and affects the intestine in 3-37% of all patients with pelvic endometriosis but it is generally asymptomatic in nature [3]. In intestinal endometriosis, the endometrial tissue infiltrates the bowel wall through the subserosal fat and usually into the muscularis propria [4]. This is termed Deep Infiltrative Endometriosis (DIE) which is defined as either >5 mm of invasion of endometrial tissue through the peritoneum or endometrial tissue invading below the peritoneum regardless of depth [5].…”