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Niger J Clin Pract. 2018 Aug;21(8):1081-1085. doi: 10.4103/njcp.njcp_29_18.

Intestinal obstruction secondary to cecal endometriosis.

Author information

1
Department of Pathology, University of Benin, P.M.B. 1154; Department of Morbid Anatomy, University of Benin Teaching Hospital, P.M.B 1111, Benin City, Edo State, Nigeria.
2
Department of Surgery, University of Benin; Department of Surgery, University of Benin Teaching Hospital, Ugbowo, Benin City, Edo State, Nigeria.
3
Department of Morbid Anatomy, University of Benin Teaching Hospital, P.M.B 1111, Benin City, Edo State, Nigeria.
4
Department of Anatomic Pathology, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.

Abstract

Endometriosis of the gastrointestinal tract is rare and occurs in <1% of all patients undergoing major gynecological surgeries. Bowel involvement has been reported in 3%-37% of all women of childbearing age with endometriosis. Total obstruction of the gastrointestinal tract occurs in <1% of cases of endometriosis with bowel obstruction. This case report is that of a 42-year-old female who presented with a 6-month history of change in bowel habits in favor of increasing constipation. This was associated with cyclical lower abdominal pains, abdominal swelling, and weight loss. Examination revealed hyperactive bowel sounds with scant fecal matter on rectal examination. An impression of intestinal obstruction was made and she had an emergency laparotomy. Dilated ileum and a hard, constricting cecal mass were found intraoperatively. She had a right hemicolectomy and ileo-transverse anastomosis, with progressive improvement postoperatively. Histology of the resected bowel segment confirmed cecal endometriosis. In conclusion, cecal endometriosis is a rare cause of intestinal obstruction. A high index of suspicion is required for diagnosis, especially if the woman is premenopausal with a history of abdominal pain that worsens with menstrual periods. Outcome is good with appropriate surgical intervention.

KEYWORDS:

Cecal endometriosis; cyclical abdominal pain; endometrioma; intestinal obstruction

PMID:
30074015
DOI:
10.4103/njcp.njcp_29_18
[Indexed for MEDLINE]
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