[Endometriosis in the sigmoid colon causing obstruction with lymph node involvement].

Area of Science:

• Gastroenterology
• Gynecology
• Surgical Pathology

Background:

• Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus.
• Lymph node involvement in endometriosis is uncommon and can mimic malignant processes.
• Diagnosis can be challenging, often requiring surgical exploration.

Purpose of the Study:

• To present a case of intestinal obstruction secondary to endometriosis with lymph node involvement.
• To discuss the diagnostic and therapeutic challenges associated with this rare presentation.
• To highlight the importance of considering endometriosis in the differential diagnosis of bowel obstruction.

Main Methods:

• Case report of a 50-year-old woman presenting with subacute and then complete intestinal obstruction.
• Inconclusive imaging examinations.
• Emergency Hartmann’s resection of the sigmoid colon with end-stoma formation.
• Histopathological examination and immunohistochemistry of the surgical specimen.

Main Results:

• Histology confirmed extensive endometriosis with lymph node involvement.
• Malignant, metastatic, or other non-malignant processes were excluded.
• The patient underwent emergency surgery for intestinal obstruction.

Conclusions:

• Endometriosis with lymph node involvement can present as intestinal obstruction, mimicking malignancy.
• Accurate diagnosis requires thorough histopathological evaluation.
• Treatment strategies, including surgery and medical management, should be individualized to prevent complications and recurrence.