Bowel endometriosis: a diagnostic and therapeutic challenge
Beng Kwang Ng1, Su Ee Phon2, Ani Amelia Zainuddin2
1Department of Obstetrics and Gynaecology, UKM Medical Centre, Jalan Yaacob Latiff, Cheras, 56000 Kuala Lumpur, Malaysia, Phone: +603-91455949, Fax: +603-91456672.
Abstract:
Bowel endometriosis is the most common extragenital manifestation of endometriosis. Clinical suspicion is of utmost importance for achieving its diagnosis. Management of this condition is, however, always challenging to the gynaecologist. We report a case of bowel endometriosis in which the patient presented with dyschezia and haematochezia prior to her menses for the past 2 years. A 44-year-old para two woman presented with worsening dysmenorrhea and dyspareunia. She also experienced dyschezia and haematochezia prior to her menses for the past 2 years. An examination revealed a fixed retroverted uterus. A computed tomography scan showed focal bowel thickening. She underwent a colonoscopy examination and biopsy that revealed stromal endometriosis. She was subsequently treated with dienogest and became asymptomatic. Diagnosis and management of this debilitating illness was revisited and discussed.
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