Intestinal endometriosis as a cause of intestinal stenosis. A case report

José M. Ruvalcaba-Vallarta, General Surgery Service, Hospital General Agustin O’Horan, Mérida, Yucatán, Mexico
Jesús A. Ruvalcaba-Velázquez, General Surgery Service, Hospital General Agustin O’Horan, Mérida, Yucatán, Mexico
Shadid A. Rodríguez-Gómez, General Surgery Service, Hospital General Agustin O’Horan, Mérida, Yucatán, Mexico
Gerardo Bracamontes-Patiño, General Surgery Service, Hospital General Agustin O’Horan, Mérida, Yucatán, Mexico
Ma. Andrea Segovia-Cabañas, General Surgery Service, Hospital General Agustin O’Horan, Mérida, Yucatán, Mexico

Endometriosis affecting the terminal ileum is a rare condition, appearing in 1-7% of women with endometriosis, with secondary intestinal occlusion estimated in 7-23%. Diagnosis before surgery is difficult and requires a high clinical suspicion; it should be a differential diagnosis in all women with abdominal pain. The clinical case is a 26-year-old female presented with abdominal pain and a lack of bowel movements, with poor response to medical management. A computed tomography scan shows signs suggestive of intestinal obstruction, leading to surgical treatment. A diagnostic laparoscopy was initially planned; however, due to the unavailability of the necessary equipment, a laparotomy was performed. Two areas of stenosis were found in the terminal ileum, managed with a right hemicolectomy and ileocolic anastomosis. Pathology reports revealed endometriotic implants in the areas of obstruction. In conclusion, while there is not established consensus regarding surgical management, a minimally invasive approach is recommended when feasible. Diagnosis can be confirmed only on histopathological examination of the surgically resected specimen. The decrease in abdominal pain, gastrointestinal discomfort, and the improvement in the quality of life are evident following surgical treatment.

Keywords: Ileal endometriosis. Right hemicolectomy. Occlusion. Intestinal resection. Endometriosis. Stenosis.