Intestinal endometriosis. Our experience

Laparoscopic management of a small bowel obstruction caused by an endometriotic focus

Endometriosis is the presence of extra-uterine endometrial tissue and affects 6-10% of fertile women. In 3-37% of the cases it affects the gastrointestinal tract being the ileal location extremely infrequent. Symptoms are nonspecific, debuting as intestinal obstruction in 7-23% of cases. The definitive diagnosis is anatomopathological and the treatment in these cases of acute abdomen is surgery. We attach the present case due to its rarity, it is a young asymptomatic woman who debuts with a picture of intestinal obstruction that is treated by intestinal resection via laparoscopy confirming the endometriosis etiology.

Ileocecal endometriosis as an infrequent cause of intussusception

We present a case of ileocecal endometriosis as a cause of infrequent ileocolic intussusception in an adult patient. It is reviewed as published by the authors Sanchez Cifuentes, A et al. 2016, emphasizing the rarity of the location of endometriosis, and its association as a cause of intussusception.

Bowel obstruction secondary to deep infiltrating endometriosis of the ileum

Deep infiltrating endometriosis (DIE) of the ileum is an uncommon lesion that may be severe in its clinical presentation. Its diagnosis is challenging in the absence of a gynecological history of endometriosis and because of its anatomical location. We read the article by Sánchez, Candel, and Albarracín, and now report an additional case that was managed urgently.

Transanal endoscopic microsurgery in the management of rectal wall endometriosis

A 29-year-old woman with known history of endometriosis was referred to colorectal outpatient clinic from gynaecology with a history of intermittent rectal bleeding and no associated bowel symptoms. Flexible sigmoidoscopy in concordance with pelvic MRI revealed a 3×2×2 cm sessile lesion in the anterior rectal wall. The lesion was also palpable as a firm mass on digital rectal examination. From the gynaecological point of view no intra-abdominal exploration was required; the sole rectal wall lesion was removed with the minimally invasive surgical technique of transanal endoscopic microsurgery. Full thickness rectal wall excision sample was reported to be histologically complete and confirmed endometriosis. No recurrence was detected at endoscopic follow-up at 6 months. The patient remained symptom free. Therefore, we demonstrated a case of minimally invasive removal of a rectal wall large endometriosis nodule in a fertile woman with a complete, symptomatic, uneventful recovery.