[BOWEL ENDOMETRIOSIS - CASE OF RECTAL LOCALISATION.]

Area of Science:

• Gastroenterology
• Gynecology
• Surgical Oncology

Background:

• Endometriosis is a common gynecological condition, but its occurrence in the gastrointestinal tract, particularly causing intestinal obstruction, is rare.
• The rectum and sigmoid colon are the most frequently affected sites in women with gastrointestinal endometriosis.

Observation:

• A 49-year-old woman presented with secondary intestinal obstruction over 2-3 months.
• Imaging revealed severe inflammation and distension of the colon due to a 1 cm stenosis from the Bauhin's valve to the rectal ampula.
• Two large tumors on the posterior and posterior-left rectal wall and plaque-like lesions on the anterior wall were identified.

Findings:

• Surgical resection (anterior resection of the rectum) was performed due to the obstruction.
• Histological examination confirmed transmural endometriosis involving the mucosa, muscularis propria, and serosa of the colon wall.
• The presentation mimicked malignancy, posing differential diagnostic challenges.

Implications:

• Surgical treatment for intestinal endometriosis, despite its complexity, offers significant benefits.
• Effective management improves clinical symptoms and enhances the overall quality of life for affected patients.