Severe Pelvic Endometriosis Involving the Rectum with Near Complete Bowel Obstruction: A Case Report

Shelby Naegele, Stephen F. Bush, Paul Bown, Nadim Bou Zgheib
In: Marshall Journal of Medicine · 2023 · vol. 9(2) · doi:10.33470/2379-9536.1388 · W4384705657
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This case report details the surgical management of a 44-year-old woman whose severe rectal endometriosis caused near complete bowel obstruction, presenting as constipation and anemia.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This case report describes a 44-year-old woman with known endometriosis who developed constipation, decreased appetite, iron deficiency anemia, and weight loss over 6 months. Colonoscopy revealed a partially obstructing mass in the proximal rectum, with biopsy showing no malignancy, and the lesion was surgically removed as part of a combined robotic-assisted hysterectomy with bilateral salpingo-ophorectomy and low anterior resection with reanastomosis. Pathology confirmed the rectal mass was consistent with endometriosis and again found no malignancy, and the authors note the limitation that this is a single-patient report without generalizable incidence or treatment comparisons. This paper is centrally about endometriosis — specifically severe rectal endometriosis presenting as near complete bowel obstruction.

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Abstract

Endometriosis is a common gynecological disease among reproductive-age women that can result in chronic pain, severely decreased quality of life, and infertility. We present a case of a 44-year-old female with a known history of endometriosis who presented with constipation, decreased appetite, iron deficiency anemia, and unintentional weight loss for 6 months. Investigation with colonoscopy discovered a partially-obstructing mass in her proximal rectum and no evidence of malignancy on biopsy. The mass was subsequently removed during a combined robotic-assisted total hysterectomy with bilateral salpingo-ophorectomy and low anterior resection with reanastomosis. Surgical pathology determined that the mass was consistent with endometriosis and no malignancy was identified. This case calls attention to a unique manifestation of endometriosis and highlights the importance of maintaining a broad differential diagnosis while utilizing a multidisciplinary team in the management of a rectal mass in reproductive-age women.
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Keywords

rectal endometriosis, rectal mass, pelvic mass Disciplines Medicine and Health Sciences

Abstract

Endometriosis is a common gynecological disease among reproductive-age women that can result in chronic pain, severely decreased quality of life, and infertility. We present a case of a 44-year-old female with a known history of endometriosis who presented with constipation, decreased appetite, iron deficiency anemia, and unintentional weight loss for 6 months. Investigation with colonoscopy discovered a partially-obstructing mass in her proximal rectum and no evidence of malignancy on biopsy. The mass was subsequently removed during a combined robotic-assisted total hysterectomy with bilateral salpingo-ophorectomy and low anterior resection with reanastomosis. Surgical pathology determined that the mass was consistent with endometriosis and no malignancy was identified. This case calls attention to a unique manifestation of endometriosis and highlights the importance of maintaining a broad differential diagnosis while utilizing a multidisciplinary team in the management of a rectal mass in reproductive-age women. Recommended Citation Naegele S, Bush S, Bown P, Bou Zgheib N. Severe Pelvic Endometriosis Involving the Rectum with Near Complete Bowel Obstruction: A Case Report. Marshall J Med. 2023; 9(2) DOI: https://doi.org/10.33470/2379-9536.1388.

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endometriosisinfertility

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