Endoscopic diagnosis of colonic endometriosis

Involvement of the colon or rectum with endometriosis is uncommon but may be a cause of gastrointestinal symptoms such as diarrhea, pain, and bleeding. To determine whether endoscopy has a role in evaluating endometriosis of the colon, we reviewed all cases of endometriosis undergoing colonic resection from 1984 to 1989. There were nine patients, six of whom had intermittent hematochezia. All had lesions detected at endoscopy described as a polyp, mass, or stricture. Five of the six patients with symptoms of hematochezia had mucosal involvement in the resected specimen. Four of these five had a visible lesion at endoscopy with endometriosis on biopsy. The three patients without hematochezia had no mucosal endometriosis in the resected colonic specimen or endometrial tissue on biopsy. In patients with colonic endometriosis and hematochezia, endoscopy and biopsy can confirm the diagnosis of colonic endometriosis.