VP62.44: Intestinal endometriosis: a rare case of intestinal perforation

Deep endometriosis (DE) is defined as the presence of endometrial tissue penetrating more than 5 mm into the peritoneum. Locations of DE include rectum, uterosacral ligament, the torus uteri, rectum, vagina, and urinary tract. Ultrasonography (US) should be the first line imaging method for assessing patients with suspected DE. 42-year-old woman, was referred for transvaginal (TV) US to investigate chronic pelvic pain (PP). She referred severe dysmenorrhea since menarche, intense pelvic pain, dyspareunia, dysuria, and dyschezia. US demonstrated: bilateral thickening of the uterosacral ligament; adenomyosis; interrupted junctional zone; endometriotic cystic in the posterior portion of the uterus and vesicouterine septum; bladder wall thickening (C) and mild hydronefrosis (D). There was an extensive lesion on the left side involving sigmoid, affected the paracolpus, parametrium, lateral wall of the pelvis, and extended through a previous Caesarean scar to the rectus abdominis muscle and subcutaneous (A,B,C). One month after USTV, she started feeling more severe abdominal pain and fever, developed sepsis and was admitted to the ICU for investigation. An abdominal tomography identified an intestinal rupture. As the patient quickly evolved into a severe condition, she died before undergoing surgery. Although rare, intestinal perforation due to E may occur, with severe complications. Intestinal E lesions may be missed. It is essential to recognise that intestinal perforation by E is a cause of acute abdomen in women. US should be used in DE, with standardised protocols, by an experienced sonographer, especially where resources are low. Supporting information can be found in the online version of this abstract Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.