Intestinal Endometriosis: A Rare Clinical Image of Sigmoid Presentation

A 47-year-old female patient with a history of umbilical endometriosis and iron deficiency anemia presented to the gastroenterology department with a year-long complaint of abdominal pain, rectal pain, and hematochezia during menstruation. Both the physical examination findings and the results of the laboratory investigations of the patient were unre- markable. A contrast magnetic resonance imaging of the abdomen revealed pathological thickening of 1.5 cm in the middle segment of the rectum, and choco- late cysts on both ovaries. The patient was referred for colonoscopic evaluation with suspicion of infil- trative endometriosis or colon neoplasm. An upper endoscopy and colonoscopy were performed while the patient was menstruating. An actively bleeding mass in sigmoid colon, partially restricting the lumen but al- lowing for the passage of the video colonoscope, was observed ( Figure 1). Biopsy specimens taken from the sigmoidal mass during colonoscopy displayed features consistent with endometriosis. A definite diagnosis of endometriosis was made. The patient underwent surgi- cal intervention by sigmoid colon resection, hysterec- tomy, and bilateral oophorectomy. The patient’s complaints ceased on postoperative follow-up. Turkiye Klinikleri J Intern Med. 2023;8(2):71-2 71 Intestinal Endometriosis: A Rare Clinical Image of Sigmoid Presentation Bağırsak Endometriyozisi: Nadir Bir Sigmoid Prezentasyonun Klinik Resmi Şafak KIZILTAŞa, Mert Doruk BALa aAcıbadem Mehmet Ali Aydınlar University Faculty of Medicine, Department of Internal Medicine, İstanbul, Türkiye ORIGINAL IMAGE ORİJİNAL GÖRÜNTÜ DOI: 10.5336/intermed.2023-100210 Correspondence: Mert Doruk BAL Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, Department of Internal Medicine, İstanbul, Türkiye E-mail: [email protected] Peer review under responsibility of Turkiye Klinikleri Journal of Internal Medicine. Re ce i ved: 10 Nov 2023 Received in revised form: 17 Nov 2023 Ac cep ted: 30 Jan 2024 Available online: 31 Jan 2024 2458-8733 / Copyright © 2023 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Türkiye Klinikleri İç Hastalıkları Dergisi Turkiye Klinikleri Journal of Internal Medicine FIGURE 1: Sigmoid lesion. 72 Source of Finance During this study, no financial or spiritual support was received neither from any pharmaceutical company that has a direct con- nection with the research subject, nor from a company that pro- vides or produces medical instruments and materials which may negatively affect the evaluation process of this study. Conflict of Interest No conflicts of interest between the authors and / or family mem- bers of the scientific and medical committee members or mem- bers of the potential conflicts of interest, counseling, expertise, working conditions, share holding and similar situations in any firm. Authorship Contributions Control/Supervision: Şafak K ızıltaş; Data Collection and/or Processing: Mert Doruk Bal; Analysis and/or Interpretation: Şafak K ızıltaş, Mert Doruk Bal; Writing the Article: Şafak Kızıltaş, Mert Doruk Bal; Critical Review: Şafak Kızıltaş, Mert Doruk Bal. Şafak KIZILTAŞ et al. Turkiye Klinikleri J Intern Med. 2023;8(2):71-2 72