Endometriosis is a common benign gynaecological disorder, which has an increased prevalence amongst twins and first degree relatives of affected individuals. Here we describe a case of remarkable resemblance in the distribution of deep infiltrating endometriosis related to the bowel in a monozygotic twin pair. We provide a literature review of studies of endometriosis in twins. We propose that genetic factors influence the nature and distribution of the disease, while environmental factors may affect the severity.
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