A Rare Cause of Bowel Obstruction Mimicking Colon Cancer: Endometriosis

Sami Açar, Erman ÇİFTÇİ, Handan ÇETİNER, Murat Apı
In: Journal of Clinical Obstetrics & Gynecology · 2022 · vol. 32(1) , pp. 27–31 · doi:10.5336/jcog.2021-85436 · W4225934497
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes a premenopausal woman with rectosigmoid endometriosis causing complete bowel obstruction, highlighting the diagnostic challenges and the importance of considering this condition in younger women with gastrointestinal obstructions.

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

This paper reports a rare case of intestinal endometriosis causing complete bowel obstruction that clinically mimicked rectal cancer in a 41-year-old premenopausal woman with pelvic pressure and difficulty stooling. The authors describe multiple colonoscopies showing a rectal mass, pelvic MRI findings suspicious for malignancy with lymphadenopathy, and inability to establish a definitive diagnosis from endoscopic tissue samples; after developing ileus, the patient underwent surgery with oncologic principles and a diverting loop ileostomy. Definitive pathology identified rectal endometriosis involving the mucosa, submucosa, and muscular layers with luminal protrusion and immunohistochemical positivity consistent with endometrial tissue, while the resected lymph nodes showed reactive changes. The case’s main limitation is that it is a single-patient report, and the diagnostic uncertainty before surgery persisted despite three colonoscopic evaluations. This paper is centrally about endometriosis — it presents a case of rectal/ampulla recti endometriosis that led to mechanical bowel obstruction mimicking colon cancer.

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Abstract

Intestinal involvement is observed in a significant portion of patients diagnosed with endometriosis. Involvement is often on the serosal surface of the sigmoid colon. Rarely, it takes place in the colonic mucosa and lymph nodes, causing lumen obstruction. Colonoscopic biopsies may be insufficient in the differential diagnosis of malignancy and diverticulitis. We report a case of a 41-year-old premenopausal female patient with endometriosis located in the ampulla recti causing complete intestinal obstruction. Although having a significant rectal mucosal mass, the diagnosis could not be made with tissue samples taken by endoscopy. During the examination, the patient developed ileus. With the preliminary diagnosis of rectal cancer, surgical intervention was applied with oncological principles, and its treatment was performed with opening a diverting ileostomy. Diagnosis of rectosigmoid endometriosis is difficult. In women of childbearing age, rectosigmoid endometriosis should be kept in mind in lower gastrointestinal tract obstructions.

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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 (17)

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