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Intestinal Endometriosis Masquerading as Common Digestive Disorders

Intestinal Endometriosis Masquerading as Common Digestive Disorders Abstract Intestinal endometriosis mimics a wide variety of inflammatory, infectious, or neoplastic digestive diseases. To alert clinicians to its diverse manifestations, we describe nine patients who required laparotomy. The underlying diagnosis was elusive initially. In no case were symptoms clearly cyclic or temporally related to phases of the menstrual cycle. Presenting complaints included acute or subacute lower abdominal pain (three patients), hematochezia (two patients), signs or symptoms of small-bowel obstruction (two patients), peritonitis (one patient), and a partially obstructing sigmoid lesion (one patient). The findings of barium enema were nondiagnostic in the five cases in which it was performed. Surgery was needed in each case; indications included inability to exclude carcinoma (two patients), small-bowel obstruction (two patients), diffuse peritonitis (one patient), persistent colonic obstruction (one patient), pericolonic abscess (one patient), and intractable pain (one patient). Intestinal endometriosis has a diverse clinical spectrum, with nonspecific features in many patients. This disease should be considered during the evaluation of unexplained digestive complaints in women of childbearing years. (Arch Intern Med. 1995;155:977-980) References 1. Olive DL, Schwartz LB. Endometriosis. N Engl J Med . 1993;328:1759-1769.Crossref 2. Prystowsky JB, Stryker SJ, Ujiki GT, Poticha SM. Gastrointestinal endometriosis: incidence and indications for resection. Arch Surg . 1988;123: 855-858.Crossref 3. Weed JC, Ray JE. Endometriosis of the bowel. Obstet Gynecol . 1987;69:727-730. 4. Croom RD III, Donovan ML, Schwesinger WH. Intestinal endometriosis. Am J Surg . 1984;148: 660-667.Crossref 5. Zwas FR, Lyon DT. Endometriosis: an important condition in clinical gastroenterology. Dig Dis Sci . 1991;36:353-364.Crossref 6. Rio FW, Edwards DL, Regan JF, Schmutzer KJ. Endometriosis of the small bowel. Arch Surg . 1970;101:403-405.Crossref 7. Martinbeau PW, Pratt JH, Gaffey TA. Small bowel obstruction secondary to endometriosis. Mayo Clin Proc . 1975;50:239-243. 8. Henrickson E. Endometriosis. Am J Surg . 1956; 90:331-336.Crossref 9. Samper ER, Slagle GW, Hand AM. Colonic endometriosis: its clinical spectrum. South Med J . 1984;77:912-914.Crossref 10. Aronchick CA, Brooks FP, Dyson WL, Baron R, Thompson JJ. Ileocecal endometriosis presenting with abdominal pain and gastrointestinal bleeding. Dig Dis Sci . 1983;28:566-572.Crossref 11. Sievert W, Sellin JH, Stringer CA. Pelvic endometriosis simulating colonic malignant neoplasm. Arch Intern Med . 1989;149:935-938.Crossref 12. Gorell HA, Cyr DR, Wangky, Greer BE. Rectosigmoid endometriosis: diagnosis using endovaginal sonography. J Ultrasound Med . 1989;8:459-461. 13. Forsgren H, Lindhagen J, Melander S, Wagermark J. Colorectal endometriosis. Acta Chir Scand . 1983;149:431-435. 14. Parr NJ, Murphy C, Holt S, Zakhour H, Crosbie RB. Endometriosis and the gut. Gut . 1988;29: 1112-1115.Crossref 15. Farinon AM, Vadora E. Endometriosis of the colon and rectum: an indication for perioperative colonoscopy. Endoscopy . 1980:12:136-139. 16. Townell NH, Vanderwalt JD, Jagger JM. Intestinal endometriosis: diagnosis and management. Br J Surg . 1984;71:629-630.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Intestinal Endometriosis Masquerading as Common Digestive Disorders

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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1995.00430090127013
Publisher site
See Article on Publisher Site

Abstract

Abstract Intestinal endometriosis mimics a wide variety of inflammatory, infectious, or neoplastic digestive diseases. To alert clinicians to its diverse manifestations, we describe nine patients who required laparotomy. The underlying diagnosis was elusive initially. In no case were symptoms clearly cyclic or temporally related to phases of the menstrual cycle. Presenting complaints included acute or subacute lower abdominal pain (three patients), hematochezia (two patients), signs or symptoms of small-bowel obstruction (two patients), peritonitis (one patient), and a partially obstructing sigmoid lesion (one patient). The findings of barium enema were nondiagnostic in the five cases in which it was performed. Surgery was needed in each case; indications included inability to exclude carcinoma (two patients), small-bowel obstruction (two patients), diffuse peritonitis (one patient), persistent colonic obstruction (one patient), pericolonic abscess (one patient), and intractable pain (one patient). Intestinal endometriosis has a diverse clinical spectrum, with nonspecific features in many patients. This disease should be considered during the evaluation of unexplained digestive complaints in women of childbearing years. (Arch Intern Med. 1995;155:977-980) References 1. Olive DL, Schwartz LB. Endometriosis. N Engl J Med . 1993;328:1759-1769.Crossref 2. Prystowsky JB, Stryker SJ, Ujiki GT, Poticha SM. Gastrointestinal endometriosis: incidence and indications for resection. Arch Surg . 1988;123: 855-858.Crossref 3. Weed JC, Ray JE. Endometriosis of the bowel. Obstet Gynecol . 1987;69:727-730. 4. Croom RD III, Donovan ML, Schwesinger WH. Intestinal endometriosis. Am J Surg . 1984;148: 660-667.Crossref 5. Zwas FR, Lyon DT. Endometriosis: an important condition in clinical gastroenterology. Dig Dis Sci . 1991;36:353-364.Crossref 6. Rio FW, Edwards DL, Regan JF, Schmutzer KJ. Endometriosis of the small bowel. Arch Surg . 1970;101:403-405.Crossref 7. Martinbeau PW, Pratt JH, Gaffey TA. Small bowel obstruction secondary to endometriosis. Mayo Clin Proc . 1975;50:239-243. 8. Henrickson E. Endometriosis. Am J Surg . 1956; 90:331-336.Crossref 9. Samper ER, Slagle GW, Hand AM. Colonic endometriosis: its clinical spectrum. South Med J . 1984;77:912-914.Crossref 10. Aronchick CA, Brooks FP, Dyson WL, Baron R, Thompson JJ. Ileocecal endometriosis presenting with abdominal pain and gastrointestinal bleeding. Dig Dis Sci . 1983;28:566-572.Crossref 11. Sievert W, Sellin JH, Stringer CA. Pelvic endometriosis simulating colonic malignant neoplasm. Arch Intern Med . 1989;149:935-938.Crossref 12. Gorell HA, Cyr DR, Wangky, Greer BE. Rectosigmoid endometriosis: diagnosis using endovaginal sonography. J Ultrasound Med . 1989;8:459-461. 13. Forsgren H, Lindhagen J, Melander S, Wagermark J. Colorectal endometriosis. Acta Chir Scand . 1983;149:431-435. 14. Parr NJ, Murphy C, Holt S, Zakhour H, Crosbie RB. Endometriosis and the gut. Gut . 1988;29: 1112-1115.Crossref 15. Farinon AM, Vadora E. Endometriosis of the colon and rectum: an indication for perioperative colonoscopy. Endoscopy . 1980:12:136-139. 16. Townell NH, Vanderwalt JD, Jagger JM. Intestinal endometriosis: diagnosis and management. Br J Surg . 1984;71:629-630.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: May 8, 1995

References