Acute Large Bowel Obstruction Caused by Endometriosis Requiring Sigmoidectomy

Area of Science:

• Gastroenterology
• Gynecology
• Surgical Pathology

Background:

• Large bowel obstruction (LBO) is a significant surgical emergency, accounting for approximately 25% of all bowel occlusions.
• Colonic malignancy is the most frequent cause of LBO (around 60%), but other etiologies like adhesions, diverticulosis, and inflammatory bowel disease (IBD) also contribute.
• Endometriosis is a rare cause of LBO, often presenting diagnostic challenges.

Observation:

• A 36-year-old female presented with symptoms of LBO, including nausea, vomiting, and abdominal pain.
• Initial diagnosis suspected diverticulitis, but further investigation revealed endometriosis tissue adhered to the colonic wall.
• The adherence caused significant narrowing of the intestinal lumen, leading to the obstruction.

Findings:

• Confirmed endometriosis as the cause of LBO in a young female patient.
• Demonstrated the potential for endometriosis to mimic other common causes of bowel obstruction.
• Highlighted the importance of considering extragenital endometriosis in cases of LBO.

Implications:

• This case underscores the need for a broad differential diagnosis in LBO, including rare causes like endometriosis.
• Accurate diagnosis of endometriosis-induced LBO is crucial for appropriate surgical and medical management.
• Further research into the mechanisms and prevalence of endometriosis causing LBO may improve patient outcomes.