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Unusual presentation of more common disease/injury
CASE REPORT
Insidious perforation of the rectum by a fallopian tube: the need to keep 'an open mind' when dealing with deep infiltrating endometriosis (DIE)
  1. Ana Teresa Marujo1,
  2. Bruna Abreu2,
  3. Bruno Nogueira3,
  4. José Reis3
  1. 1Gynecology Department, Maternidade Dr Alfredo da Costa, Lisbon, Portugal
  2. 2Gynecology, Hospital Beatriz Angelo, Loures, Lisboa, Portugal
  3. 3Gynecology Department, Hospital Beatriz Angelo, Loures, Lisboa, Portugal
  1. Correspondence to Dr Ana Teresa Marujo, anatmarujo{at}hotmail.com

Summary

Endometriosis is a benign chronic disease which can have different degrees of severity and can potentially affect any organ. Intestinal endometriosis occurs in 3%–37% of the cases, being more frequent in the rectosigmoid transition. Transmural involvement of intestinal endometriosis is extremely rare and is usually associated with recurrent abdominal pain. Due to the cyclical hormone influence, endometriosis implants may infiltrate the deeper layers of the intestinal wall and may lead to bowel obstruction or perforation. We present a case of transmural perforation of the rectum wall by an adjacent organ (left fallopian tube) that occurred insidiously in a patient with deep infiltrative endometriosis. A complete set of images is presented, regarding the preoperative, intraoperative and postoperative findings.

  • Reproductive Medicine
  • Obstetrics And Gynaecology
  • Gastrointestinal Surgery

https://doi.org/10.1136/bcr-2017-220248

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    Footnotes

    • Contributors All authors contributed for this work. ATM: Substantial contributions to the design and conception of the paper and also for acquisition, analysis and interpretation of data. BA: Important contribution to the conception of the paper and also for acquisition of data. BN: Drafting the work or revising it critically for important intellectual content. JR: Drafting the work or revising it critically for important intellectual content and final approval of the version published.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.