Bifocal Intestinal Endometriosis Mimicking Colonic Tumor: A Case Report

Introduction: Endometriosis is a gynaecological disorder, defined as presence of endometrial glands and/or stroma in any location outside the endometrial cavity and it is usually seen in women of reproductive age group. It involves many organs including the intestine and may cause acute large bowel obstruction. Case Presentation: A 32-year-old nulligravida woman presented with 5 years history of recurrent constipation, recurrent lower abdominal pain, menstrual irregularities and dysmenorrhea. An assessment of intestinal obstruction and multiple uterine leiomyoma was made following series of investigations including plain abdominal x-ray, abdomino-pelvic ultrasound, CT and proctoscopy. She had exploratory laparotomy and a mass was found in the caecum and transverse colon with multiple mesenteric lymph nodes. She subsequently had extended right hemicolectomy with ileo-colic anastomosis and myomectomy. Postoperative condition of the patient was satisfactory. The diagnosis of bifocal intestinal endometriosis was made on histopathological assessment. Conclusion: It is advised that endometriosis should be part of differential diagnosis in a young woman presenting with recurrent signs and symptoms of intestinal obstruction and colonic mass especially on a background of dysmenorrhea.