Acute endometrial bowel obstruction—A rare indication for colonic stenting

Christopher Whelton, Arnab Bhowmick
International journal of surgery case reports · 2012 · vol. 4(2) , pp. 160–163 · doi:10.1016/j.ijscr.2012.11.007 · PMID:23276756 · W2023269258
article OA: gold CC0 ⤵ 17 in-corpus citations
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This case report describes the successful use of colonic stenting as an acute intervention to bridge to elective surgery for a patient with bowel obstruction caused by an endometriotic rectal stricture.

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Abstract

INTRODUCTION: Pelvic endometriosis is an extremely rare cause of large bowel obstruction and the management can be challenging. Urgent surgery for acute colonic obstruction is known to carry high morbidity and mortality, and operation may be made more difficult in extensive pelvic endometriosis. Less invasive alternatives in the acute situation may need to be considered. PRESENTATION OF CASE: Presented is the case of a 35-year-old lady with obstructive bowel symptoms caused by an endometriotic upper rectal stricture. She was initially treated using radiologically guided stent insertion, as an acute intervention, prior to an elective bowel resection and hysterectomy with bilateral salpingo-oophorectomy. DISCUSSION: Colonic stenting is currently widely used in malignant obstruction. The use of self expanding metallic stents (SEMS) to treat benign conditions is controversial, however, due to associated long term complications. This case demonstrates that stenting can provide a bridge to major surgery in the rare event of acute endometriotic colonic obstruction. The initial acute treatment with stenting provides the advantage of time to involve the multi-disciplinary team, to medically optimise the patient and to better plan the definitive surgery. CONCLUSION: The use of radiologically guided stents has a place in the treatment of benign recto-sigmoid obstruction due to endometriosis and therefore should be considered as a bridge to further surgical treatment.

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Condition tags

endometriosis

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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.

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