Rectosigmoid endometriosis, a rare cause of lower GI bleeding in a premenopausal woman: Case report.

INTRODUCTION AND

IMPORTANCE

Endometriosis is a common gynecological condition where endometrial-like tissue grows outside the uterus, often affecting the ovaries, peritoneum, and pelvic ligaments. Sigmoid endometriosis is a rare manifestation that can present with nonspecific gastrointestinal symptoms, often mimicking conditions like irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD), posing significant diagnostic challenges. This case report emphasizes the importance of considering sigmoid endometriosis in patients with chronic abdominal pain and gastrointestinal disturbances.

CASE PRESENTATION: A 35-year-old female, para 1 + 2 living 1, with no comorbidities, presented with a 4-year history of colicky lower abdominal pain, radiating to the perianal region, associated with alternating episodes of loose stools and constipation. Her symptoms were cyclical, worsening with menstruation. Her gynecological history included irregular cycles, menorrhagia, and anemia. Initial gynecological evaluations were unremarkable. A subsequent colonoscopy revealed a rectosigmoid mass, and biopsy findings suggested inflammatory changes. Further imaging and multidisciplinary evaluation led to exploratory laparotomy and rectosigmoid mass resection. Histopathology confirmed sigmoid endometriosis.

CLINICAL DISCUSSION: Sigmoid endometriosis is rare and can mimic common gastrointestinal disorders. Diagnosis is often confirmed through colonoscopy and histopathology. Surgical resection is the main treatment for symptomatic patients, with laparoscopic surgery preferred. Hormonal therapies can be adjunctive. Early diagnosis is key to improving outcomes.

CONCLUSION

Sigmoid endometriosis should be considered in women with cyclic gastrointestinal symptoms. Early diagnosis through colonoscopy and histopathology under multidisciplinary team approach followed by surgical intervention, when necessary, leads to better management and outcomes.