{"paper_id":"14012cfa-90a1-4905-a293-6c64a9c6f58d","body_text":"Abstract\nWe report a case of sigmoid endometriosis diagnosed preoperatively based on endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) findings. A 42-year-old female came to us with left lower abdominal pain and bloating that had started 3 months prior. CT and MRI results showed wall thickening of the sigmoid colon. A colonoscopy procedure could not be completed because passage through the sigmoid colon was blocked due to severe stenosis, while mucosal biopsy samples obtained during that procedure could not confirm a diagnosis. EUS-FNA was then performed and specimens were obtained from the muscular layer with stenosis, which revealed a thickened hypoechoic lesion. Histological findings obtained by use of EUS-FNA demonstrated a large amount of fibrosis in endometrial glands and a diagnosis of sigmoid endometriosis was confirmed by additional immunostaining. Thus, a laparoscopic sigmoidectomy was performed, with sigmoid endometriosis finally diagnosed. Confirmation of a diagnosis of intestinal endometriosis based on histological findings of mucosal biopsy specimens obtained by colonoscopy is difficult, because endometrial implants are primarily located in the serosal and/or muscular layer. When safe aspiration is possible, we consider that EUS-FNA can be an effective method for preoperative diagnosis of intestinal endometriosis, which may contribute to avoidance of unnecessary or excessive surgery.\nSimilar content being viewed by others\nReferences\nVercellini P, Viganò P, Somigliana E, Fedele L, et al. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol. 2014;10:261–75.\nKoninckx PR, Ussia A, Adamyan L, et al. Deep endometriosis: definition, diagnosis, and treatment. Fertil Steril. 2012;98:564–71.\nAbrao MS, Petraglia F, Falcone T, et al. 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Ryoji Hyakudomi and Yoshitsugu Tajima contributed to preparation of the surgical findings. Makiko Nagase, Noriyoshi Ishikawa, and Riruke Maruyama contributed to preparation of the pathological findings. Yoshikazu Kinoshita was the supervisor of this case report and added important opinions regarding the findings. All the authors have read and approved the final version of the manuscript.\nCorresponding author\nEthics declarations\nConflict of interest\nNone of the authors have personal or financial conflicts to declare.\nHuman and animal rights statement\nAll the procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.\nInformed consent\nInformed consent was obtained from the patient for being included in the study.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nKishimoto, K., Kawashima, K., Moriyama, I. et al. Sigmoid endometriosis diagnosed preoperatively using endoscopic ultrasound-guided fine-needle aspiration. Clin J Gastroenterol 13, 158–163 (2020). https://doi.org/10.1007/s12328-019-01046-x\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s12328-019-01046-x","source_license":"CC0","license_restricted":false}