A Case Report of an Asymptomatic Rectal Endometriosis Diagnosed by the Endoscopic Biopsy Specimen

Jun‐ichi Miyazaki, Shigeaki Nagao, Keiichi Sugimoto, Atsushi Kawaguchi, Atsuhiro Iwai, Shigetaka Tounou, Shigeaki Aono, Tsutomu Yamaguchi, Takefumi Kitagawa, Tatsushi Shiomi, Hassou Ohtsuka, Hiroshi Koyama, Tohru Miyahara, Kunihiko Hino, Shintarou Terahata
In: Progress of Digestive Endoscopy(1972) · 1996 · vol. 48(0) , pp. 212–213 · doi:10.11641/pdensks.48.0_212 · W2326892116
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This case report describes an asymptomatic rectal endometriosis, classified as an endometrioma, diagnosed via endoscopic biopsy of a subpedunculated polyp.

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This case report describes a 47-year-old female with asymptomatic rectal endometriosis identified during an examination for a flat elevation near the anal verge. The diagnosis was confirmed via endoscopic biopsy of a small, reddish polyp, which was classified as an intramural endometrioma rather than diffuse disease. The authors note that colorectal endometriosis is rare and difficult to diagnose endoscopically, often presenting with symptoms like pain or bleeding, whereas this patient exhibited none. They emphasize that the specific type of lesion and the timing within the menstrual cycle significantly impact the accuracy of histological diagnosis through biopsy. This paper is centrally about endometriosis — specifically focusing on the rare presentation and diagnostic challenges of deep infiltrating rectal endometriosis.

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Abstract

We reported here a rare case of an asyptomatic rectal endometriosis diagnosed by endoscopy. A 47-year-old female was referred to our hospital for the further examination for a flat elevation, 15cm apart from the anal verge. Rectal endometriosis was diagnosed by the biopsy specimen from the subpedunculated polyp at the anal side of the referred lesion. It was reddish, smooth in the surface, and 7mm in diameter. It is difficult to diagnose endoscopically the colorectal endometriosis. About 10 cases have been reported for the past 10 years in Japan. Most of the chief complaints of colo-rectal endometriosis are abdominal pain, bloody stool, constipation, vomiting, and etc with a review of the literature. This case was asymptomatic. Colorectal endometriosis may be classified into two types. One is an endometrioma, the intramural tumor consisting of the endometrial grands with hemorrhage. Another is a diffuse endometriosis, the lesions of stenosis with fibrosis in the intestinal wall. This case was classified into the endometrioma. It must be considered that types of endometriosis as well as menstrual period greatly affects the diffinite histological diagnosis by the endoscopic biopsy specimen.
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症例 内視鏡検査にて診断しえた無症状の大腸子宮内膜症の1例 1996 年 48 巻 p. 212-213 詳細 抄録 We reported here a rare case of an asyptomatic rectal endometriosis diagnosed by endoscopy. A 47-year-old female was referred to our hospital for the further examination for a flat elevation, 15cm apart from the anal verge. Rectal endometriosis was diagnosed by the biopsy specimen from the subpedunculated polyp at the anal side of the referred lesion. It was reddish, smooth in the surface, and 7mm in diameter. It is difficult to diagnose endoscopically the colorectal endometriosis. About 10 cases have been reported for the past 10 years in Japan. Most of the chief complaints of colo-rectal endometriosis are abdominal pain, bloody stool, constipation, vomiting, and etc with a review of the literature. This case was asymptomatic. Colorectal endometriosis may be classified into two types. One is an endometrioma, the intramural tumor consisting of the endometrial grands with hemorrhage. Another is a diffuse endometriosis, the lesions of stenosis with fibrosis in the intestinal wall. This case was classified into the endometrioma. It must be considered that types of endometriosis as well as menstrual period greatly affects the diffinite histological diagnosis by the endoscopic biopsy specimen. Colorectal endometriosis may be classified into two types. One is an endometrioma, the intramural tumor consisting of the endometrial grands with hemorrhage. Another is a diffuse endometriosis, the lesions of stenosis with fibrosis in the intestinal wall. This case was classified into the endometrioma. It must be considered that types of endometriosis as well as menstrual period greatly affects the diffinite histological diagnosis by the endoscopic biopsy specimen. © 1996 一般社団法人 日本消化器内視鏡学会 関東支部

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