Colorectal endometriosis: Five years’ experience in this enigmatic problem: Colorectal endometriosis

Introduction Endometriosis affects primarily women of reproductive age and is responsible for impairing their quality of life. Presence of severe symptoms, stenosis of the intestinal lumen, diagnostic difficulty (suspicion of malignancy) and intolerance to hormonal therapy are indications for surgery. Despite numerous studies concerning endometriosis, there is still considerable controversy about its incidence, pathogenesis, diagnosis and optimal treatment. Methods This retrospective observational study includes 11 patients who were diagnosed with intestinal endometriosis between January 2009 and December 2013. Demographic data, clinical presentation, diagnostic modalities, localization of the disease and intraoperative data were collected. Results Median age of the patients was 43 (34–63). Eight patients had intermittent abdominal pain, seven had change in bowel habits and three had for rectal bleeding. Seven patients were operated on for severe stenosis of the intestinal lumen (intestinal obstruction) and three for a suspected malignancy. Postoperatively all of the patients who underwent resection were free of pain. No patient had any disease recurrence on USG or CT images. Discussion Intestinal endometriosis should be considered in female patients of reproductive age presenting with constipation, rectal bleeding and abdominal pain. Also repeated inadequate biopsies should raise suspicion of intestinal endometriosis. Intestinal endometriosis is a rare disease with diagnostic difficulties and despite medical management, treatment options are usually surgery. But in patients who were diagnosed preoperatively and did not have intestinal obstruction, medical therapy may be tried.