A Case of Recurrence of Severe Extensive Pelvic Endometriosis with Rectal Invasion

This paper reports a case of recurrent severe extensive pelvic endometriosis in a 28-year-old nulligravid woman who had already undergone two conservative operations, presenting with massive vaginal bleeding and severe lower abdominal pain attributed to rectal invasion. Despite receiving a 4000 mL blood transfusion and danazol therapy (800 mg/day) for one month, the condition could not be improved, and the authors concluded conservative treatment was not feasible because lesions occupied the whole pelvis with marked adhesions between the uterus and adjacent organs. They performed a hysterectomy with adnexectomy, finding endometriotic foci filling the cul-de-sac and growing into the rectal lumen with infiltrative growth through the rectal wall; histopathology showed benign endometriosis with dilated glands surrounded by decidua-like stroma without atrophy. This paper is centrally about endometriosis — a recurrent case of extensive pelvic disease with rectal invasion treated surgically.

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