Colonic obstruction in a 45 year old female

We present a case of an unusual cause of colonic obstruction in a 45 year old female. The woman presented at the emergency department with a large bowel obstruction. Computed tomography of the abdomen showed distension of the colon with a lesion in the sigmoid colon with suspicion of a colonic malignancy. She underwent an urgent Hartmann procedure. Histology of the resection specimen revealed endometriosis. This patient did not have any symptoms suggestive of endometriosis. When a woman of childbearing age presents with large bowel obstruction, endometriosis should be considered in the differential diagnosis. This patient had a hysterectomy with bilateral salpingo-oophorectomy, what maked the diagnosis of endometriosis less evident.