Gastrointestinal endometriosis: a diagnostic challenge

Endometriosis is a clinical entity defined by the presence of functional endometrial tissue outside the uterus. Endometriosis of the sigmoid colon is an extremely rare cause of large bowel obstruction. It can remain asymptomatic for a long period of time until signs and symptoms of obstruction occur. We present the case of a 50-year-old female patient with endometriosis of the sigmoid colon and manifestations of bowel obstruction. The stenotic lesion of the colon was discovered in a virtual colonoscopy. Biopsy of the lesion was not performed because of the inability of the colonoscope to pass through the stenotic lesion. During exploratory laparotomy, a sigmoidectomy for suspected malignancy was performed with colo-colonic anastomosis. The diagnosis of endometriosis was made by the pathologist. Though gastrointestinal endometriosis is not an uncommon entity, large bowel obstruction due to endometriosis is extremely rare and preoperative diagnosis is still challenging. An accurate anamnesis is very important for the surgeon who should consider this entity, especially in women of fertile age. The most appropriate therapeutic approach demands a multidisciplinary team that includes a gynaecologist, a general surgeon and an expertise psychologist. Similar content being viewed by others

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