Intestinal obstruction by deep enteric endometriosis: case report and literature review

Daniel Benito Castillo Martínez, Doris Michelle Palacios Rivera, Emmanuel Stephano Bracho Ruíz, Sergio Sandoval Tapia, Mariano Tovar Ponce, Julio C. Gómez Trejo, Diana Iraís Hernández Hernández, César Augusto López Carmona, Rafael Silva Flores
In: International Journal of Research in Medical Sciences · 2022 · vol. 10(12) , pp. 2945 · doi:10.18203/2320-6012.ijrms20223102 · W4310296973
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report and literature review details a 26-year-old female's surgical management of deep enteric endometriosis causing small bowel obstruction, highlighting surgery as the definitive treatment with varying complication rates.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper reports a 26-year-old woman with 72 hours of abdominal pain, vomiting, and inability to pass stool or gas, in whom contrast-enhanced CT showed distal small-bowel obstruction. She underwent exploratory laparotomy with segmental resection for ileal strictures and a Brook’s ileostomy, and postoperative pathology supported deep enteric endometriosis; her postoperative course was uneventful and she later received dienogest. The authors’ literature review emphasizes that preoperative diagnosis of deep enteric endometriosis causing bowel obstruction is difficult, surgery is typically definitive, bowel resection is reserved for major stenosing lesions, and complication rates (including anastomotic leakage and recurrence/stenosis) vary across studies, with an explicit acknowledgment that medical therapy may reduce symptoms but does not replace resection for obstruction. This paper is centrally about endometriosis — specifically deep enteric endometriosis presenting as small-bowel obstruction treated with surgical resection and postoperative dienogest.

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Abstract

Deep endometriosis (DE) is an uncommon cause of bowel obstruction; preoperative diagnosis is a challenging task due to its rarity and pathological confirmation. Surgery is the appropriate treatment and complications are common. A 26-year-old Latin female was admitted to emergency department with 72 hours history of abdominal pain associated with inability to pass stool or gas, vomiting and nausea. Abdominal distention and pain without acute abdomen signs. Laboratory tests reported normal. Abdominal contrast-enhanced computed tomography showed distal small bowel obstruction. Patient underwent exploratory laparotomy with segmental resection bearing ileal strictures and Brook´s ileostomy was performed. Postoperative course of patient was uneventful and after pathology report treatment with dienogest was established. DE remains challenging entity to treat, medical treatment can reduce symptoms, but surgical resection is required. Bowel resection is reserved for mayor stenosis lesions. Anastomotic leakage is frequent. Surgery represents the definitive treatment for bowel obstruction by DE. Resection improves pain and intestinal symptoms. Recurrence, stenosis, and anastomotic leakage rates vary across the studies. Surgical and medical treatment should be considered.

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Condition tags

endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (32)

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last seen: 2026-06-10T17:14:06.276822+00:00
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