A Case of Intestinal Obstruction due to Rectal Endometriosis

This case report describes a 49-year-old woman who presented with severe rectal stenosis and difficulty defecating two years after undergoing a total hysterectomy for adenomyosis and uterine fibroids. Preoperative evaluations revealed normal endoscopic findings but elevated CA125 levels, leading to an exploratory laparotomy that confirmed deep infiltrating endometriosis involving the rectal muscularis propria and serosa. The authors note that intestinal endometriosis typically affects submucosal layers or deeper, making preoperative diagnosis via biopsy difficult, which was consistent with the Group 1 biopsy results in this patient. This paper is centrally about endometriosis — specifically the presentation of deep infiltrating rectal endometriosis causing intestinal obstruction following prior surgery for adenomyosis.

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