Endometriosis and bowel comorbidities

Endometriosis is an estrogen-dependent gynecological condition characterized by the presence and growth of ectopic endometrial tissue, often associated with inflammation, severe and chronic pain, and infertility. Lesions are categorized as superficial peritoneal lesions, endometriomas, or deep infiltrating nodules, with high degree of individual variability in lesion color, size, and morphology. Numerous factors involved in this disease, including inflammation, angiogenesis, cytokine/chemokine expression, and endocrine alterations such as steroid and steroid receptor expression. \nWhen endometrial-like glands and stroma infiltrate the bowel wall, reaching at least the subserous fat tissue or the adjacent subserous plexus, the condition is diagnosed as intestinal endometriosis. \nMatherial and methods \nThe aim of this study is to analyze the bowel comorbidities of the endometriosis. In particular, the frequency of endometriosis in young women with abdominal pain and to evaluate the most feared complication after surgery. \nIn the first time, we consider the young fertile age women with right iliac fossa (RIF) pain . This is one of the most common complaint in those presenting at the emergency department and requiring acute care. \nA group of fertile age women (18-45 years) undergoing emergency surgery for acute RIF pain \nAccording to the intraoperative and pathology findings, patients were subdivided into 2 groups: group A was composed by those with histological diagnosis of endometriosis, whereas group B identified the controls. During the surgery, peritoneal samples were taken and analized. The present study showed that in women undergoing appendectomy for a RIF pain, superficial peritoneal endometriosis (SUP) is an incidental diagnosis in 23% of cases. \nIn the second time, we consider the bowel endometriosis. When endometriosis infiltrate the bowel wall, reaching at least the subserous fat tissue or the adjacent subserous plexus, the condition is diagnosed as intestinal endometriosis \nMedical treatments include nonsteroidal anti-inflammatory drugs, oral contraceptives, progesterone, and gonadotropin-releasing hormone. Instead, surgical treatment includes shaving or resection. \nWe performed this study with the aim of identifying the number of leaks in colonic resections for deep endometriosis. \nConclusions \nEndometriosis is a very common condition in fertile young women. Knowing the degree of infiltration and deciding on the best treatment strategy should not be undervalued.