Intestinal endometriosis masquerading as common digestive disorders

Area of Science:

• Gastroenterology
• Gynecology
• Surgical Pathology

Background:

• Intestinal endometriosis is a rare condition that can present with a wide range of gastrointestinal symptoms.
• It often mimics other digestive diseases, including inflammatory, infectious, and neoplastic conditions, leading to diagnostic challenges.
• Symptoms are frequently nonspecific and not clearly related to the menstrual cycle, complicating early identification.

Purpose of the Study:

• To highlight the diverse clinical manifestations of intestinal endometriosis.
• To alert clinicians to the potential for this condition to mimic other gastrointestinal diseases.
• To emphasize the importance of considering intestinal endometriosis in the differential diagnosis of unexplained digestive complaints in women.

Main Methods:

• Retrospective case series of nine patients requiring laparotomy for suspected or confirmed intestinal endometriosis.
• Review of presenting symptoms, diagnostic workup including barium enema, and surgical findings.
• Analysis of indications for surgery and final diagnoses.

Main Results:

• Presenting symptoms were diverse and included abdominal pain, hematochezia, small-bowel obstruction, peritonitis, and sigmoid lesions.
• Diagnosis was often elusive preoperatively, with symptoms lacking clear cyclic correlation.
• Barium enema findings were nondiagnostic in all cases where performed.
• Surgical intervention was necessary in all nine patients for various indications, including suspicion of malignancy, obstruction, and peritonitis.

Conclusions:

• Intestinal endometriosis exhibits a broad spectrum of clinical presentations with often nonspecific symptoms.
• The condition frequently mimics other gastrointestinal pathologies, necessitating a high index of suspicion.
• Consideration of intestinal endometriosis is vital in evaluating women of childbearing age with unexplained digestive issues.