Intestinal obstruction caused by endometriotic deposits: A case report

Introduction: Endometriosis is a benign gynecological condition affecting women of reproductive age. The condition principally presents with symptoms like dysmenorrhea, pelvic pain and subfertility. Although endometriosis in the gastrointestinal tract is not an uncommon occurrence, it causing acute intestinal obstruction has been seldom reported in literature. Case report: We present a case history of a 40 year old woman, who had presented with acute intestinal obstruction. A sigmoid colectomy was done for suspected malignant obstruction of rectosigmoid junction. Histology revealed endometriotic tissue deposits. Discussion: Incidence of endometrial tissue in the gastrointestinal tract greatly varies according to the site. Greatest incidence is reported to be in the sigmoid colon and rectum. Acute intestinal obstruction can infrequently occur due to endometriosis. Clinical diagnosis in such a case can be challenging, so is radiological confirmation. A combination of medical and surgical therapies can be attempted for endometriosis. In emergency presentation surgery plays a pivotal role in relieving the obstruction be it a Hartmann’s procedure or placement of a stent. Conclusion: Intestinal endometriosis should be considered a differential diagnosis in women of reproductive age, presenting with intestinal obstruction, which requires a high index of suspicion where relevant, given the history.