Intestinal endometriosis: an uncommon cause of rectal bleeding

Rachel Pui Wai Kwok, Kwok RM, R M Kwok, F J Moawad, Fouad J. Moawad, Moawad FJ, J T Laczek, Jeffrey Laczek, Laczek JT, Horwhat JD, J D Horwhat, John D. Horwhat
Endoscopy · 2010 · vol. 42(S 02) , pp. E112–E113 · doi:10.1055/s-0029-1243943 · PMID:20306398 · W2005367250
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A 43-year-old woman with a history of uterine myomectomy presented with cyclical hematochezia, leading to the diagnosis of intestinal endometriosis as an uncommon cause of rectal bleeding.

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This case report describes a 43-year-old woman presenting with cyclic hematochezia, lower abdominal cramping, and a history of uterine myomectomy. Diagnostic evaluation via colonoscopy and endoscopic ultrasound revealed a subepithelial rectal mass with thickened muscularis propria contiguous with the uterus, leading to a diagnosis of intestinal endometriosis after noting mucosal changes during menstruation. The patient achieved complete resolution of symptoms following treatment with oral contraceptives and a gonadotropin-releasing hormone analog, highlighting that hormonal therapy is effective for mild disease. This paper is centrally about endometriosis — specifically the presentation, diagnosis, and medical management of deep infiltrating intestinal endometriosis causing rectal bleeding.

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Abstract

A 43-year-old woman was evaluated for hematochezia. The patient reported monthly episodes lasting 3 days, consisting of lower abdominal cramping and small amounts of bright red blood with every bowel movement. Her history was notable for uterine myomectomy.
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References

1 Chapron C, Fauconnier A, Dubuisson JB et al. Deep infiltrating endometriosis: relation between severity of dysmenorrhoea and ex- tent of disease. Hum Reprod 2003; 18: 760 – 766 2 Macafee CH, Greer HL. Intestinal endome- triosis. A report of 29 cases and a survey of the literature. J Obstet Gynaecol Br Emp 1960; 67: 539 – 555 3 Remorgida V, Ferrero S, Fulcheri E et al. Bowel endometriosis: presentation, diagnosis, and treatment. Obstet Gynecol Surv 2007; 62: 461 – 470 4 Olive DL, Pritts EA. Treatment of endome- triosis. N Engl J Med 2001; 345: 266 – 275

Bibliography

DOI 10.1055/s-0029-1243943 Endoscopy 2010; 42: E112 – E113 © Georg Thieme Verlag KG Stuttgart · New York · ISSN 0013-726X Corresponding author R. M. Kwok, MD Department of Medicine Walter Reed Army Medical Center 6900 Georgia Avenue Washington DC 20307 USA Fax: +1-202-782-4955 [email protected] UCTN – Unusual cases and technical notes E113 Kwok RM et al. Intestinal endometriosis … Endoscopy 2010; 42: E112 – E113 This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Gastrointestinal Hemorrhage Rectal Diseases Adult Adult Colonoscopy Colonoscopy Endometriosis Endometriosis Endometriosis Endosonography Endosonography Female Female Gastrointestinal Hemorrhage Gastrointestinal Hemorrhage Humans Humans Rectal Diseases Rectal Diseases

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