{"paper_id":"2ec325f6-1499-46c1-9c59-89a32225836e","body_text":"Abstract\nIntroduction\nEndometriosis is a common chronic gynaecological disease affecting 10 % of women of reproductive age. Of these 5–12 % may present bowel endometriosis that may be asymptomatic or associated with aspecific symptoms even bowel obstruction.\nCase presentation\nThe case of a 41-year-old woman with history of ulcerative colitis, previous diagnosis of ovarian endometriosis, recurrent abdominal pain not related to the menstrual cycle, with abdominal pain and obstinate constipation for 2 weeks was referred. The patient underwent colonoscopy, transabdominal ultrasound and ultrasound-guided fine-needle biopsy to have a diagnosis.\nDiscussion\nEndometriosis should be considered in the differential diagnosis of every woman of childbearing age who presents with gastrointestinal or abdominal symptoms. As demonstrated in our case and by the burgeoning literature in this field, we believe that the role of transabdominal ultrasound should be reconsidered in the management of abdominal diseases because this examination associated with ultrasound-guided fine-needle biopsy allows, in expert hands, to obtain adequate histological samples avoiding patients to undergo more invasive tests to get a diagnosis.\nRiassunto\nIntroduzione\nL’endometriosi è una malattia ginecologica cronica comune che colpisce il 10 % delle donne in età riproduttiva. Nel 5–12 % si può presentare una localizzazione intestinale della malattia. Essa può presentarsi in svariati modi potendo essere asintomatica o potendosi manifestare con sintomi aspecifici includendo perfino l’occlusione intestinale.\nCaso clinico\npresentiamo il caso di una donna di 41 anni affetta da colite ulcerosa, con storia di precedente diagnosi di endometriosi ovarica e ricorrenti dolori addominali non correlati al ciclo mestruale. Riferisce da circa due settimane il peggioramento dei dolori addominali cui si associa stipsi ostinata. È stata quindi sottoposta a colonscopia, ecografia transaddominale e biopsia ecoguidata per via transaddominale prima di poter fare una diagnosi.\nDiscussione\nL’endometriosi dovrebbe essere considerata nella diagnosi differenziale in ogni donna in età fertile che si presenta con sintomi gastrointestinali o addominali vaghi. Come nel caso clinico illustrato e alla luce della fiorente letteratura in questo campo, riteniamo che il ruolo dell’ecografia transaddominale dovrebbe essere riconsiderato nella gestione delle malattie addominali. Infatti, l’ecografia transaddominale associata alla possibilità di poter eseguire in corso dello stesso esame una biopsia ecoguidata, permetterebbe di poter ottenere un adeguato campione istologico evitando al paziente esami più invasivi per raggiungere una diagnosi.\nReferences\nLin Y-H, Kuo L-J, Chuang A-Y, Cheng T-I, Hung C-F (2006) Extrapelvic endometriosis complicated with colonic obstruction. J Chin Med Assoc 69(1):47–50\nCrosignani P, Olive D, Bergqvist A, Luciano A (2006) Advances in the management of endometriosis: an update for clinicians. Hum Reprod Update 12(2):179–189 Epub 2005 Nov 9\nKazadi BJ, Alcazar JL, Laparte MC, Lopez GG (1992) Catamenial rectal bleeding and sigmoid endometriosis. J Gynecol Obstet Bio Rep 21(7):773–774\nDe Ceglie A, Bilardi C, Blanchi S, Picasso M, Di Muzio M, Trimarchi A, Conio M (2008) Acute small bowel obstruction caused by endometriosis: a case report and review of the literature. World J Gastroenterol 14(21):3430–3434\nNasim H, Sikafi D, Nasr A (2011) Sigmoid endometriosis and a diagnostic dilemma - A case report and literature review. Int J Surg Case Rep 2(7):181–184. doi:10.1016/j.ijscr.2011.06.001\nBascombe NA, Naraynsingh V, Dan D, Harnanan D (2013) Isolated endometriosis causing sigmoid colon obstruction: a case report. Int J Surg Case Rep 12:1073–1075. doi:10.1016/j.ijscr.2013.09.015\nAnaf V, Nakadi IE, Simon P et al (2004) Preferential infiltration of large bowel endometriosis along the nerves of the colon. Hum Reprod 19(4):996–1002\nKaraman K, Pala EE, Bayol U, Akman O, Olmez M, Unluoglu S, Ozturk S (2012) Endometriosis of the terminal ileum: a diagnostic dilemma. Case Reports Pathol. doi:10.1155/2012/742035\nPatrelli TS, Berretta R, Gizzo S, Pezzuto A, Franchi L, Lukanovic A et al (2011) CA 125 serum values in surgically treated endometriosis patients and its relationships with anatomic sites of endometriosis and pregnancy rate. Fertil Steril 95(1):393–396\nde Sio Ilario, Funaro Annalisa, Vitale Luigi Maria et al (2013) Ultrasound-guided percutaneous biopsy for diagnosis of gastrointestinal lesions. Dig Liver Dis 45:816–819\nCarson BW, Brown JA, Cooperberg PL (1998) Ultrasonographically guided percutaneous biopsy of gastric, small bowel, and colonic abnormalities: efficacy and safety. Ultrasound Med 17:739–742\nConflict of interest\nThe authors Terracciano Fulvia, Scalisi Giuseppe, Attino Vito and Biscaglia Giuseppe declares that they have no conflicts of interest.\nInformed consent\nAll procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). All patients provided written informed consent to enrolment in the study and to the inclusion in this article of information that could potentially lead to their identification.\nHuman and animal studies\nThe study was conducted in accordance with all institutional and national guidelines for the care and use of laboratory animals.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nTerracciano, F., Scalisi, G., Attino, V. et al. A rare case of sigmoid colon obstruction in patient with ulcerative colitis: role of transabdominal ultrasound-guided biopsy. J Ultrasound 18, 411–414 (2015). https://doi.org/10.1007/s40477-014-0105-6\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s40477-014-0105-6","source_license":"CC0","license_restricted":false}