Mucosal changes in the large bowel with endometriosis: A possible cause of misdiagnosis of colitis?

Langlois NE, Neil E. I. Langlois, N E Langlois, Park KG, Kenneth G. M. Park, K G Park, Ronald A. Keenan, R A Keenan, Keenan RA
Human pathology · 1994 · vol. 25(10) , pp. 1030–1034 · doi:10.1016/0046-8177(94)90061-2 · PMID:7927307 · W2094143829
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This paper examines mucosal changes in the large bowel associated with endometriosis and explores their potential to be misdiagnosed as colitis.

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Abstract

Endometriotic deposits are not uncommon in the large bowel of women. Because the symptoms produced by endometriosis may lead to investigation by colorectal endoscopic biopsy, the aims of this study were to assess the range of mucosal abnormalities that may occur and to determine whether this could represent a significant potential diagnostic problem. We found mucosal changes in eight of 10 cases of colorectal endometriosis; however, the abnormalities (ulceration, gland architectural disturbance, crypt abscess formation, increased inflammatory cell presence, and smooth muscle fibers between glands in the mucosa) were focal and directly related to endometrial deposits. In one case an abnormal colonic biopsy specimen from a patient with endometriosis supported the erroneous clinical diagnosis of Crohn's disease. Comparing a group of women with endometriosis to a group with adenomyosis of the uterus showed that although more women with endometriosis have endoscopic large bowel biopsies, there was no significant excess of biopsy specimens showing inflammatory changes. Our conclusion is that the endometriosis of the large bowel can masquerade as inflammatory bowel disease or ischemic changes and the possibility should be borne in mind, particularly in cases with atypical clinical features or very focal histological changes.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Intestinal Mucosa Intestine, Large Adult Diagnosis, Differential Endometriosis Female Humans Inflammatory Bowel Diseases Inflammatory Bowel Diseases Intestinal Mucosa Intestine, Large

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 (34)

Cited by (50)

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