A Case of Colorectal Endometriosis Diagnosed by Endoscopic Biopsy

Toshio Katakami, Yoshihiko Kubota, Yoshimi Mori, Shigeki Kaneta, Kenichi Nakada, Shinsuke Shimizu, Tomoko Kobayashi, Kouichi Watanabe, Kazuhiko Tsuchiya, Asako Katayama, Masaaki Miyaoka, Toshihiko Saito
In: Progress of Digestive Endoscopy(1972) · 1996 · vol. 48(0) , pp. 210–211 · doi:10.11641/pdensks.48.0_210 · W2327141043
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This case report describes a 40-year-old woman with colorectal endometriosis diagnosed via endoscopic biopsy, presenting with rectosigmoid stenosis and elevated lesions despite intact mucosal surfaces.

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This case report describes a 40-year-old woman with positive immunological fecal occult blood who underwent further diagnostic evaluation for suspected intestinal pathology. Imaging revealed stenosis in the sigmoid colon, and subsequent colonoscopy identified an elevated lesion that was biopsied to confirm the presence of heterotopic endometrium and stroma within the tissue sample. The authors note that while intestinal endometriosis is rare and typically difficult to diagnose via biopsy due to intact mucosal surfaces, this specific presentation allowed for a definitive histological diagnosis. This paper is centrally about endometriosis — specifically colorectal involvement diagnosed through endoscopic biopsy.

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Abstract

The patient was a 40-year-old female. She was pointed out positive of immunological fecal occult blood in physical examination. She had further examinations in our hospital. Barium enema X-ray revealed granulated shadow and poor extension of intestinal wall in the rectosigmoid, and revealed intestinal stenosis on one side of the sigmoid colon. Colonoscopic examination showed an elevated lesion covered with granulated mucosa, and that was pushed out from one side. Histologically, there was heterotopic endometrium accompanied with stroma in biopsied specimen. Then we diagnosed it colorectal endometriosis. Pelvic CT showed bilateral ovarian cysts and hypertrophic intestine. Endoscopic ultrasonography showed hypertropy of the 4th layer and brindled hypoechoic lesion from the 1st to the 3rd layer in the intestinal wall. Intestinal endometriosis is a rare disease. And it is difficult to make a diagnosis by endoscopic biopsy, because the mucosal surface is intact in most cases. We experienced a case of colorectal endometriosis diagnosed by endoscopic biopsy. So we reported this case and discussed it and some in the literature.
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抄録 The patient was a 40-year-old female. She was pointed out positive of immunological fecal occult blood in physical examination. She had further examinations in our hospital. Barium enema X-ray revealed granulated shadow and poor extension of intestinal wall in the rectosigmoid, and revealed intestinal stenosis on one side of the sigmoid colon. Colonoscopic examination showed an elevated lesion covered with granulated mucosa, and that was pushed out from one side. Histologically, there was heterotopic endometrium accompanied with stroma in biopsied specimen. Then we diagnosed it colorectal endometriosis. Pelvic CT showed bilateral ovarian cysts and hypertrophic intestine. Endoscopic ultrasonography showed hypertropy of the 4th layer and brindled hypoechoic lesion from the 1st to the 3rd layer in the intestinal wall. Intestinal endometriosis is a rare disease. And it is difficult to make a diagnosis by endoscopic biopsy, because the mucosal surface is intact in most cases. We experienced a case of colorectal endometriosis diagnosed by endoscopic biopsy. So we reported this case and discussed it and some in the literature. Barium enema X-ray revealed granulated shadow and poor extension of intestinal wall in the rectosigmoid, and revealed intestinal stenosis on one side of the sigmoid colon. Colonoscopic examination showed an elevated lesion covered with granulated mucosa, and that was pushed out from one side. Histologically, there was heterotopic endometrium accompanied with stroma in biopsied specimen. Then we diagnosed it colorectal endometriosis. Pelvic CT showed bilateral ovarian cysts and hypertrophic intestine. Endoscopic ultrasonography showed hypertropy of the 4th layer and brindled hypoechoic lesion from the 1st to the 3rd layer in the intestinal wall. Intestinal endometriosis is a rare disease. And it is difficult to make a diagnosis by endoscopic biopsy, because the mucosal surface is intact in most cases. We experienced a case of colorectal endometriosis diagnosed by endoscopic biopsy. So we reported this case and discussed it and some in the literature. © 1996 一般社団法人 日本消化器内視鏡学会 関東支部

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