A Case of Rectal Endometriosis Operated after Four Years of the Histological Diagnosis

This paper reports a 41-year-old woman with rectal endometriosis who had been treated with LH-RH analogs for left ovarian endometriosis since 1996. In 1998, she presented with menstrual-cycle-associated rectal bleeding and defecatory difficulty, and colonoscopy with biopsy confirmed rectal endometriosis; symptoms improved on hormonal therapy but recurred in 2002 with worsening defecatory difficulty and rectal bleeding. After further evaluation identified rectal stenosis, she underwent hysterectomy, bilateral adnexectomy, and low anterior resection of the rectum, with postoperative pathology showing endometriosis with prominent fibrosis from the serosa to the submucosa and an uncomplicated recovery. The authors conclude that even when hormone therapy is effective for intestinal endometriosis, surgery can become necessary after long-term progression, highlighting the need for adequate observation. This paper is centrally about endometriosis—specifically rectal (intestinal) endometriosis treated surgically after prolonged histologic diagnosis.

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