Published online Jun 21, 2013. doi: 10.3748/wjg.v19.i23.3707
Revised: March 27, 2013
Accepted: April 27, 2013
Published online: June 21, 2013
Bowel endometriosis affects between 3.8% and 37% of women with endometriosis. The evaluation of symptoms and clinical examination are inadequate for an accurate diagnosis of intestinal endometriosis. We describe the case of a 41-year-old woman who presented to our hospital because of six months of recurrent abdominal pain, vomiting and diarrhea, without previous history of bowel disease. Physical examination revealed a palpable 3 cm × 5 cm mass in the right lower quadrant abdomen. Laboratory tests showed slightly elevated levels of CA19-9 and CA125. Small bowel computer tomography scanning revealed an ileocecal mass with bowel wall thickening and luminal narrowing. Small bowel endoscopy identified a deep longitudinal ulcer and mucosal edema in the distal ileum. All these findings supported the diagnosis of Crohn’s disease. The patient underwent a laparotomy, which identified a 5 cm × 5 cm ileocecal mass with severe mucosal edema and luminal stricture in the distal ileum. Histopathological examination confirmed a diagnosis of ileocecal endometriosis without other areas involved. After one-year follow-up, there was no recurrence of the symptoms.
Core tip: We describe the case of a 41-year old woman who had recurrent abdominal pain with vomiting and diarrhea on presentation to our hospital. The results of computer tomography scanning and small bowel endoscopy were strongly suspicious for Crohn’s disease. However, surgery and histopathological examination confirmed a diagnosis of ileocecal endometriosis without other areas involved.