Rectal endometriosis causing colonic obstruction and concurrent endometriosis of the appendix: a case report

Nikolaos Katsikogiannis, N Katsikogiannis, Ak Tsaroucha, K Dimakis, E Sivridis, Ce Simopoulos
Journal of medical case reports · 2011 · vol. 5(1) , pp. 320 · doi:10.1186/1752-1947-5-320 · PMID:21774792 · PMC3158121 · W2109476757
article OA: gold CC0 ⤵ 33 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes a 36-year-old woman who presented with acute abdomen and colonic obstruction due to rectal endometriosis, also found concurrently in the appendix, requiring resection and temporary colostomy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This 2011 case report describes a 36-year-old woman presenting with acute abdomen and bowel obstruction, ultimately found intraoperatively to have near-complete rectosigmoid stenosis caused by rectal endometriosis. She underwent exploratory laparotomy with rectosigmoidectomy (Hartmann’s procedure) and temporary colostomy plus appendectomy; pathology confirmed endometriosis involving both the colon and appendix. Postoperatively she received medical treatment (triptorelin), and at follow-up she had restoration surgery for bowel continuity with no endometriosis found in the examined specimen. The authors note key limitations typical of emergency presentations, including lack of preoperative CT imaging and that diagnostic endoscopy was not performed, with final diagnosis relying on histopathology. This paper is centrally about endometriosis — specifically rectal endometriosis causing colonic obstruction with concurrent appendiceal endometriosis.

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Abstract

INTRODUCTION: Endometriosis is a clinical entity which presents with functioning endometrial tissue at sites outside the uterus. Bowel endometriosis is usually asymptomatic, but it may show non-specific symptoms. The presence and/or association of appendiceal endometriosis, concomitant with rectal endometriosis, is possible. CASE PRESENTATION: A 36-year-old Greek woman was admitted to the emergency room of our hospital with signs of acute abdomen. On physical examination, our patient had a painful distended abdomen. Digital examination revealed an empty rectum and bowel obstruction was diagnosed. Our patient underwent exploratory laparotomy and rectum stenosis (almost complete obstruction) was observed. The bowel stenosis was resected, and temporary colostomy and appendectomy were performed. The pathology report showed endometriosis of the colon and the appendix, and our patient received medical treatment for endometriosis. Six months after this operation our patient had another surgery for restoration of large bowel continuity. No endometriosis was found. Our patient was doing well at the one-year follow up. CONCLUSION: Endometriosis of the bowel is a disease that may cause large bowel obstruction. In women of reproductive age, the surgeon should consider endometriosis as a differential diagnosis in case of various gastrointestinal symptoms.

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endometriosisbowel_endometriosis

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