Endometriosis masquerading as Crohn's disease in a patient with acute small bowel obstruction

Chaonan Dong, Dong C, Wee Sing Ngu, Simon E Wakefield, Simon Wakefield, Wakefield SE
BMJ case reports · 2015 · vol. 2015 , pp. bcr2014207229 · doi:10.1136/bcr-2014-207229 · PMID:25903200 · PMC4420817 · W2329309434
article OA: bronze CC0 ⤵ 6 in-corpus citations
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A 45-year-old woman initially diagnosed with Crohn's disease due to small bowel obstruction was later found to have endometriosis causing the stricture after multiple treatments and diagnostics.

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Abstract

A 45-year-old woman, a smoker, presented acutely with subacute small bowel obstruction. Abdominal CT scan showed features of ileocaecal Crohn's disease. She was treated with high dose steroids and her symptoms rapidly settled. A few days later she was discharged on a reducing steroid course in addition to azathioprine. Outpatient colonoscopy was performed and reported as normal but there was failed terminal ileal intubation. Three months later, she represented as an emergency with complete small bowel obstruction. On laparoscopy, a terminal ileal stricture was found resulting in an ileocolic resection. Histopathology reported an endometriotic stricture with no evidence of Crohn's disease. She was advised to stop steroids and azathioprine. A subsequent pelvic MRI scan showed no further endometrial deposits and she remained symptom free. This case highlights that endometriosis should always be considered when women of childbearing age present with bowel obstruction, even if the patient has no other evidence of the disease.

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Condition tags

endometriosis

MeSH descriptors

Crohn Disease Endometriosis Intestinal Diseases Intestinal Obstruction Intestine, Small Intestine, Small Intestine, Small Biopsy Colonoscopy Crohn Disease Diagnosis, Differential Endometriosis Endometriosis Female Humans Intestinal Diseases Intestinal Diseases Intestinal Obstruction Middle Aged Radiography

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 (11)

Cited by (6)

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