A Case Of Sigmoid Colon Endometriosis Confirmed By Endoscopic Biopsy

Kunihiko Obara, Hidemi Ooba, Yoshirou Tamegai, Kazuhiko Watanabe, Hidekazu Katoh
In: Progress of Digestive Endoscopy(1972) · 1997 · vol. 50(0) , pp. 296–297 · doi:10.11641/pdensks.50.0_296 · W2321140627
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This case report describes the endoscopic biopsy diagnosis of sigmoid colon endometriosis in a patient presenting with bloody stool and abdominal pain, leading to surgical resection.

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The paper reports a single case of sigmoid colon endometriosis in a 36-year-old woman who presented with bloody stool and abdominal pain associated with ileus. After admission, barium enema demonstrated sigmoid stenosis with an irregular surface, and colonoscopy revealed a nodular elevated lesion with reddening and erosion; the authors state that endoscopic biopsy specimens allowed a definite diagnosis before surgery. Sigmoidectomy was performed, and histology showed endometrial tissue spread from the serosa to the mucosa of the resected colon. The paper emphasizes that confirming endometrial tissue by endoscopic biopsy requires attention to clinical colon endometriosis features such as submucosal-tumor–like appearance and mucosal changes related to the menstrual cycle. This paper is centrally about endometriosis — it is a case report of endometriosis confirmed by endoscopic biopsy in the sigmoid colon.

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Abstract

We report a case of sigmoid colon endometriosis associated with ileus, diagnosed definitely by endoscopic biopsy before the operation. The patient was a 36-years-old woman complaining of bloody stool and abdominal pain. We performed barium enema study after the admission, and found stenosis with irregular surface in the sigmoid colon. Colonoscopy showed nodular elevated lesion with some reddening and erosion at 15cm oral side from the anus. We could diagnose definitely her endometriosis of the sigmoid colon from the biopsy specimens and the sigmoidectomy was performed. Histological examination showed the spread of the endometrial tissue penetrated from serosa to mucosa of the resected sigmoid colon. To confirm endometrial tissue by endoscopic biopsy, we have to keep the clinical characteristics of the colon endometriosis in our minds ; its forming submucosal tumor, and altering mucosal aspects in relation with the cycle of menses.
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症例 術前に確定診断しえたS状結腸子宮内膜症の1例 1997 年 50 巻 p. 296-297 詳細 抄録 We report a case of sigmoid colon endometriosis associated with ileus, diagnosed definitely by endoscopic biopsy before the operation. The patient was a 36-years-old woman complaining of bloody stool and abdominal pain. We performed barium enema study after the admission, and found stenosis with irregular surface in the sigmoid colon. Colonoscopy showed nodular elevated lesion with some reddening and erosion at 15cm oral side from the anus. We could diagnose definitely her endometriosis of the sigmoid colon from the biopsy specimens and the sigmoidectomy was performed. Histological examination showed the spread of the endometrial tissue penetrated from serosa to mucosa of the resected sigmoid colon. To confirm endometrial tissue by endoscopic biopsy, we have to keep the clinical characteristics of the colon endometriosis in our minds ; its forming submucosal tumor, and altering mucosal aspects in relation with the cycle of menses. The patient was a 36-years-old woman complaining of bloody stool and abdominal pain. We performed barium enema study after the admission, and found stenosis with irregular surface in the sigmoid colon. Colonoscopy showed nodular elevated lesion with some reddening and erosion at 15cm oral side from the anus. We could diagnose definitely her endometriosis of the sigmoid colon from the biopsy specimens and the sigmoidectomy was performed. Histological examination showed the spread of the endometrial tissue penetrated from serosa to mucosa of the resected sigmoid colon. To confirm endometrial tissue by endoscopic biopsy, we have to keep the clinical characteristics of the colon endometriosis in our minds ; its forming submucosal tumor, and altering mucosal aspects in relation with the cycle of menses. © 1997 一般社団法人 日本消化器内視鏡学会 関東支部

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