A Case of Colorectal Endometriosis Diagnosed by Endoscopic Biopsy

The patient was a 40-year-old female. She was pointed out positive of immunological fecal occult blood in physical examination. She had further examinations in our hospital. Barium enema X-ray revealed granulated shadow and poor extension of intestinal wall in the rectosigmoid, and revealed intestinal stenosis on one side of the sigmoid colon. Colonoscopic examination showed an elevated lesion covered with granulated mucosa, and that was pushed out from one side. Histologically, there was heterotopic endometrium accompanied with stroma in biopsied specimen. Then we diagnosed it colorectal endometriosis. Pelvic CT showed bilateral ovarian cysts and hypertrophic intestine. Endoscopic ultrasonography showed hypertropy of the 4th layer and brindled hypoechoic lesion from the 1st to the 3rd layer in the intestinal wall. Intestinal endometriosis is a rare disease. And it is difficult to make a diagnosis by endoscopic biopsy, because the mucosal surface is intact in most cases. We experienced a case of colorectal endometriosis diagnosed by endoscopic biopsy. So we reported this case and discussed it and some in the literature.