[Impending caecal blowout due to endometriosis]
Suzanne C Stokmans1, Mark Tenhagen, Ramon R Gorter
1Rode Kruis Ziekenhuis, afd. Chirurgie, Beverwijk.
Background:
Endometrial tissue is present outside the uterine cavity in 6-10% of fertile women. Associated symptoms such as dysmenorrhoea, dyspareunia and abdominal discomfort are non-specific. For this reason, endometriosis is not always considered in women with abdominal symptoms. Endometriosis can also manifest itself as an acute surgical emergency such as an intestinal obstruction.
Case Description:
A 29-year-old woman was admitted to our hospital with acute lower abdominal pain and vomiting. On rectal examination a firm mass was palpable. CT scan of the abdomen showed the loops of colon to be extremely dilated. As a caecal blowout seemed imminent we carried out a laparotomy which revealed an obstruction of the rectum caused by severe endometriosis.
Conclusion:
In fertile women presenting with signs of acute bowel obstruction, endometriosis should be included in the differential diagnosis and an early gynaecological consultation is indicated.
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