A Masked Diagnosis: Sigmoid Endometriosis
Lakshmipriya Subbaraj1,2, Christopher J Bowman3, Aparajita Singh2
1Department of Internal Medicine, University of California, San Francisco, San Francisco, CA.
ACG Case Reports Journal
|June 14, 2021
Summary
Intestinal endometriosis rarely infiltrates the deep mucosa, causing rectal bleeding. This case highlights endometriosis as a rare cause of abnormal bowel imaging and bleeding in women.
Area of Science:
- Gastroenterology
- Gynecologic Oncology
Background:
- Intestinal endometriosis frequently involves the serosa, typically causing nonspecific gastrointestinal symptoms.
- Deeper mucosal infiltration with rectal bleeding is an uncommon presentation.
Observation:
- A 40-year-old woman with a history of breast cancer presented with periodic rectal bleeding and abdominal pain.
- Imaging revealed sigmoid lesions suspicious for metastatic disease.
Findings:
- Colonoscopy identified hypervascular sigmoid lesions.
- Histopathology confirmed these lesions as endometriosis.
Implications:
- Endometriosis should be considered in the differential diagnosis for young women with unexplained bowel abnormalities or catamenial bleeding.
- This case underscores the importance of considering endometriosis in women with gastrointestinal symptoms, even with a history of malignancy.
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