Endometriosis: a rare cause of small bowel obstruction

Although endometriosis is a common condition in young women, symptomatic involvement of the small bowel is rare. The authors report the case of a 44-year-old lady initially thought to have irritable bowel syndrome who presented 1 month later with acute small bowel obstruction. A CT scan showed small...

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Bibliographic Details
Published in:BMJ case reports 2012-08, Vol.2012 (aug09 1), p.bcr0320125988-bcr0320125988
Main Authors: Khwaja, Samir A, Zakaria, Rasheed, Carneiro, Herman Anthony, Khwaja, Haris A
Format: Article
Language:English
Subjects:
Abdomen
Adult
Age
Appendix
Biopsy
Colectomy
Colonic Diseases - complications
Colonic Diseases - pathology
Colonic Diseases - surgery
Constriction, Pathologic - complications
Endometriosis
Endometriosis - complications
Endometriosis - pathology
Endometriosis - surgery
Europe (West)
Family medical history
Female
Histopathology
Humans
Ileal Diseases - diagnostic imaging
Ileal Diseases - etiology
Ileal Diseases - surgery
Infertility
Inflammatory bowel disease
Intestinal Obstruction - diagnostic imaging
Intestinal Obstruction - etiology
Intestinal Obstruction - surgery
Intussusception - complications
Irritable bowel syndrome
Lymphatic system
Menstruation
Pain
Patients
Radiography
Reminder of Important Clinical Lesson
Ultrasonic imaging
White
Womens health
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Description
Summary:Although endometriosis is a common condition in young women, symptomatic involvement of the small bowel is rare. The authors report the case of a 44-year-old lady initially thought to have irritable bowel syndrome who presented 1 month later with acute small bowel obstruction. A CT scan showed small bowel dilatation with a transition point in the ileum, but no distinct lesion. The patient had an exploratory laparotomy where an obstructing lesion in the terminal ileum and several enlarged mesenteric lymph nodes were identified. Consequently, a right hemicolectomy was performed. Pathology specimens showed multiple endometriotic foci in the bowel with stricturing of terminal ileum and appendiceal intussusception. This likely resulted in subocclusive episodes and intestinal obstruction. This case highlights the difficulty in establishing a preoperative diagnosis of endometriosis. Small bowel endometriosis should, therefore, be considered in the differential diagnosis of women of childbearing age who present with symptoms of obstruction.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr.03.2012.5988