Advanced Endometriosis with a Large Bowel Nodule Managed Laparoscopically Using the NOSE Technique: a Case Report and Review of Literature
This case report details the laparoscopic management of advanced endometriosis with a large bowel nodule in a 28-year-old woman using the NOSE technique.
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This preprint reports a case of a 28-year-old nulliparous woman with an eight-year history of dysmenorrhea, dyspareunia, cyclic diarrhea, and primary infertility, in whom transvaginal ultrasound and laparoscopy ultimately identified advanced endometriosis with bowel involvement (Enzian P-3 O-2/0 T-3/3 A-0 B-0/0 C-3 FA) and a rectal nodule. The patient underwent laparoscopic management that included cystectomy, peritonectomy, nodulectomy, and laparoscopic rectal nodule resection/anastomosis using the NOSE (natural orifice specimen extraction) technique, with histology confirming endometrial glands and stroma in colon tissue; the authors also emphasize a long diagnostic delay and attribute it to limited diagnostic suspicion and skills, particularly for transvaginal ultrasound. A major limitation is that this is a single case report/preprint without peer review, so the findings cannot be generalized. This paper is centrally about endometriosis — it describes advanced bowel endometriosis managed laparoscopically using the NOSE technique and focuses on diagnostic delay in a specific setting.
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References (12)
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