Endometriosis-induced acute large bowel obstruction and endometriotic deposits in pericolic lymph nodes: A case report

Abstract

Introduction:

Endometriosis is characterized by an extrauterine presence of endometrial-like glands and stroma, commonly involving the ovaries, tubes, and pelvic peritoneum. Women with endometriosis can be asymptomatic or present with various symptoms including dysmenorrhea, pain, and dyspareunia whereas intestinal obstruction is uncommon.

Case presentation:

We present a 43-year-old female with acute large bowel obstruction (LBO), originally thought to be a complication of sigmoid cancer. During exploration, an obstructive mass including the sigmoid and upper rectum was identified, it was adherent to the uterus and the ovaries. Sigmoidectomy, panhysterectomy, and end colostomy were performed. Microscopic examination of the rectosigmoid mass revealed endometrial glands and stroma along with areas of hemorrhage, and hemosiderin deposition with some inflammatory cells. Three pericolic lymph nodes were involved with endometriosis.

Conclusion:

Despite the rare association, endometriosis can be a possible cause of intestinal obstruction, posing a diagnostic challenge because it is easily confused for malignant LBO.