Crohn's disease and intestinal endometriosis: an intriguing co-existence

Craninx M, M Craninx, G D'haens, D'Haens G, K Cokelaere, Cokelaere K, Baert F, F Baert, Penninckx F, F Penninckx, A D'hoore, D'Hoore A, N Ectors, Ectors N, P Rutgeerts, Rutgeerts P, K Geboes, Geboes K
European journal of gastroenterology & hepatology · 2000 · doi:10.1097/00042737-200012020-00014 · PMID:10741938
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This case series of eight patients reveals that intestinal endometriosis can coexist with Crohn's disease, often remaining undiagnosed pre-operatively and identified only after surgical resection.

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This paper presents a case series of eight female patients who underwent surgery for complicated Crohn's disease involving the terminal ileum or colon. Histological examination of the resected specimens revealed that six patients had concurrent intestinal endometriosis, which was not suspected prior to surgery based on clinical or radiological findings. The study notes that while chronic transmural inflammation characteristic of Crohn's disease was present elsewhere, endometriotic deposits were confined to specific layers of the bowel wall. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

OBJECTIVES: We present a series of eight female patients who came to surgery for complicated Crohn's disease of the terminal ileum (n = 7) or colon (n = 1). Indications for surgery were medically intractable disease in three, steroid dependence in four and ileal perforation in one. RESULTS: Histological examination using routine haematoxylin-eosin stained sections revealed the presence of intestinal endometriosis of the ileum (n = 6), colon (n = 1) or ileum and rectum (n = 1) in addition to the typical features of Crohn's disease. In particular, chronic transmural inflammation was observed in locations other than the endometriotic deposits, which were confined to the serosa in three, the muscularis propria in two, both the serosa and the muscularis propria in one and the serosa, muscularis propria and submucosa in two. In none of these patients had the diagnosis of intestinal endometriosis been suspected pre-operatively based on clinical (gynaecological) or radiological tests. CONCLUSION: Intestinal endometriosis and Crohn's disease can occur simultaneously. The diagnosis is often only made after surgical resection of the diseased segment. In Crohn's disease, endometriosis of the terminal ileum seems more common.
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Objectives

We present a series of eight female patients who came to surgery for complicated Crohn's disease of the terminal ileum (n= 7) or colon (n= 1). Indications for surgery were medically intractable disease in three, steroid dependence in four and ileal perforation in one.

Results

Histological examination using routine haematoxylin-eosin stained sections revealed the presence of intestinal endometriosis of the ileum (n= 6), colon (n= 1) or ileum and rectum (n= 1) in addition to the typical features of Crohn's disease. In particular, chronic transmural inflammation was observed in locations other than the endometriotic deposits, which were confined to the serosa in three, the muscularis propria in two, both the serosa and the muscularis propria in one and the serosa, muscularis propria and submucosa in two. In none of these patients had the diagnosis of intestinal endometriosis been suspected pre-operatively based on clinical (gynaecological) or radiological tests.

Conclusion

Intestinal endometriosis and Crohn's disease can occur simultaneously. The diagnosis is often only made after surgical resection of the diseased segment. In Crohn's disease, endometriosis of the terminal ileum seems more common.Eur J Gastroenterol Hepatol12:217-221 © 2000 Lippincott Williams & Wilkins European Journal of Gastroenterology & Hepatology 2000, 12:217-221

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Condition tags

endometriosis

MeSH descriptors

Colonic Diseases Crohn Disease Endometriosis Ileal Diseases Adolescent Adult Colonic Diseases Colonic Diseases Colonic Diseases Crohn Disease Crohn Disease Diagnosis, Differential Endometriosis Endometriosis Endometriosis Female Humans Ileal Diseases Ileal Diseases Ileal Diseases

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SciLite annotations

chemicals 2
steroid haematoxylin

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