Endometriosis

This chapter focuses on endometriosis-related emergencies, using case reports to illustrate each clinical scenario. The numerous fibrotic foci found in the intestinal wall are consistent with chronic inflammation from endometriosis and demonstrate the progressive and constrictive nature of the disease. The mucosa may only be affected in about 10% of cases; thus, lower or upper endoscopic evaluation of the bowel lumen cannot rule out intestinal endometriosis. Many patients presenting with an acute abdomen due to bowel endometriosis are suspected of having a malignancy once the endometriotic implant is found intraoperatively, before it is examined histologically. Awareness of intestinal endometriosis presenting as an acute abdomen and mimicking malignancy helps patients receive more appropriate care. The most common site of endometriosis outside the abdominopelvic cavity is within the thoracic cavity. Thoracic disease can occur in isolation, but in 50% to 84% of patients with this diagnosis, there is concomitant pelvic endometriosis, which is typically extensive.