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Endometriosis of the Colon

Colonic Endometriosis


Presentation

  • […] and presenting the aspects of a cancer--caused serious differential diagnostic problems, and made the choice of treatment difficult.[ncbi.nlm.nih.gov]
  • Conclusions Endometriosis of the large bowel presenting with signs and symptoms of acute intestinal obstruction may mimic large bowel malignancy and present as a diagnostic dilemma as is this case.[npplweb.com]
  • Keywords: Deep infiltrating endometriosis; Colon cancer Case Presentation A forty six year old gravida two Caucasian female with medical history of essential hypertension presented to our clinic for the management of abdominal pain for five months.[austinpublishinggroup.com]
Hunting
  • Kempers RD, Dockerty MB, Hunt AB, Symmonds RE. Significant postmenopausal endometriosis. Surg Gynecol Obstet 1960;111:348–56. PubMed Google Scholar 17. Rose TF. Complicated endometriosis of the large bowel. Med J Australia 1970;1:891–6.[link.springer.com]
Pallor
  • Physical examination revealed a young woman in pain, dehydrated, warm to touch with pallor of the conjunctiva. The abdomen was distended, with generalized tenderness, guarding and rebound tenderness.[npplweb.com]
Collapse
  • The rectum was collapsed. The stricturous lesion with 5 cm margin distally and end colostomy was done. The macroscopic appearance showed an infiltrating lesion involving the wall of colon measuring 4.3x4x2.1 cm.[tropicalgastro.com]
Dyspnea
  • Browse recently published Learning/CME Learning/CME View all learning/CME CME A Trial of a Shorter Regimen for Rifampin-Resistant Tuberculosis Case 10-2019: A 69-Year-Old Man with Progressive Dyspnea Mucinous Ovarian Carcinoma Challenge Yourself Interactive[nejm.org]
Intestinal Disease
  • With increasing travel and increasing immunosuppression, parasitic intestinal diseases are now seen in every type of practice. The standard diagnostic procedures described herein reduce costs in therapy.[books.google.ro]
  • Ovarian endometriosis: a marker for more extensive pelvic and intestinal disease. Fertil Steril 1999; 72: 310-315. Mourth de Alvim Andrade M, Batista Pimenta M, de Freitas Belezia B, Duarte T. Rectal Obstruction due to endometriosis.[pelviperineology.org]
  • On the other hand, it should be routinely used to exclude other intestinal diseases of the rectum, colon, and terminal ileum that can mimic intestinal symptoms of endometriosis (present in around 60% of patients with deep endometriosis).[intechopen.com]
  • Medical treatment with hormonal therapy such as OCP, Danazol or Gonatrophin antagonists can be attempted for intestinal disease when there is no obstruction [ 1, 2, 4 ].[wjes.biomedcentral.com]
  • Ovarian endometriosis: a marker for more extensive pelvic and intestinal disease . Fertil Steril 1999; 72 :310–315. 4. Remorgida V , Ferrero S , Fulcheri E et al . Bowel endometriosis: presentation, diagnosis, and treatment .[nature.com]
Epigastric Pain
  • A 61-year-old woman, para 1, presented with epigastric pain in December 1997. She had no history of, or symptoms to suggest, the presence of endometriosis and had been receiving hormone replacement therapy for 13 years.[archivesofpathology.org]
  • It enters in the differential diagnosis of cyclical or chronic epigastric pain, especially in the context of endometriotic patients.[ncbi.nlm.nih.gov]
  • Pain Relating to Menses Can Be a Symptom of Bowel Endometriosis Science Direct – (Abstract; Nov. 2015) Bowel Complications in Endometriosis Surgery Science Direct – (Abstract; Jan. 2016) Computed Tomography-Based Virtual Colonoscopy in the Assessment[bloominuterus.com]
Abdominal Cramps
  • Other symptoms include pelvic pain associated with menses, constipation, diarrhea, abdominal cramping, and difficulty with completely evacuating the bowels (called dyschezia).[nezhat.org]
  • Symptoms unique to this condition include: pain when you have a bowel movement abdominal cramps diarrhea constipation bloating straining with bowel movements rectal bleeding Most women with bowel endometriosis also have it in their pelvis, which can cause[healthline.com]
  • Crohn’s Disease – symptoms include constipation, diarrhea, rectal bleeding, and abdominal cramping.[bloominuterus.com]
Acute Abdomen
  • Case presentation We report a case of endometriosis of the sigmoid colon, which caused complete intestinal obstruction and mimicked carcinoma of the sigmoid colon in a 30-year-old woman who presented with signs and symptoms of acute abdomen.[npplweb.com]
  • Abdomen International Journal of Surgery Case Reports – (Article, Sept. 2017) A Case Report of Endometriosis Presenting as Acute Small Bowel Obstruction JAMA Internal Medicine – (Abstract; 1995) Intestinal Endometriosis Masquerading as Common Digestive[bloominuterus.com]
Chronic Diarrhea
  • Case Report A 58-year-old woman with a history of chronic diarrhea and post-menopausal uterine bleeding underwent a routine colonoscopy for colon cancer screening, which demonstrated a large, nearly obstructing mass extending from the proximal rectum[acgcasereports.gi.org]
  • A March 2017 case study was of a 58-year-old woman who suffered from chronic diarrhea and post-menopausal bleeding. During a routine colonscopy, they found a mass extending from her rectum to her sigmoid colon.[bloominuterus.com]
Flushing
  • Sood N¹, Dhanani M², Santoni C², Landmann RG³, Geiger XJ 4 and Dinh TA 2 * ¹Department of Obstetrics and Gynecology, Flushing Hospital Medical Center, Flushing, New York, USA ²Department of Medical and Surgical Gynecology, Mayo Clinic, Jacksonville, Florida[austinpublishinggroup.com]
  • If the egg is not fertilized, it is flushed from the body along with the endometrium; this if your period.[smartlivingnetwork.com]
  • So, I am researching and testing out a bunch of tools to flush out my bowels but in the meantime, I would like to point out some other digestive symptoms which you may be experiencing which could indicate something similar going on for you: Heartburn[endoempowered.com]
Purpura
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized[nejm.org]
Encephalopathy
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized[nejm.org]

Workup

  • CASE PRESENTATION: We present a case of a young woman with sigmoid endometriosis, in which the initial diagnostic workup suggested colon cancer.[ncbi.nlm.nih.gov]
  • Because a metastatic workup was negative, the patient underwent laparotomy with rectosigmoid colon resection and low anterior reanastomosis.[archivesofpathology.org]
  • Case presentation We present a case of a young woman with sigmoid endometriosis, in which the initial diagnostic workup suggested colon cancer.[bmcgastroenterol.biomedcentral.com]
Liver Biopsy
  • Histology of a liver biopsy taken at the time of laparotomy showed metastatic clear cell carcinoma.[jcp.bmj.com]

Treatment

  • These problems were solved by peroperative coloscopy that, revealing an extrinsic compression of the colonic and rectal wall in the presence of an intact mucosa, indicated the conservative treatment of the lesions in all three cases.[ncbi.nlm.nih.gov]
  • Endometriosis of the bowel: role of bowel resection, superficial excision and oophorectomy in treatment. Ann Surg 1973;70:580–7. Google Scholar 10. Brooks JJ, Wheeler JE.[link.springer.com]

Prognosis

  • "No one really knows why the MSI-positive colorectal cancer patients have a better prognosis than the MSI-negative patients," she explained.[medscape.com]
  • The management of extrauterine endometrial stromal sarcoma is difficult, but primary surgical treatment with complete resection of all disease should be performed when feasible.10 The prognosis correlates well with stage.[archivesofpathology.org]
  • Specifically, improved prognosis was univariately associated with MSH2 deficiency, in contrast to other studies where there was no association between clinical outcomes and MSH2 expression status. 47 MMR status has been previously associated with prognosis[esmoopen.bmj.com]
  • High-grade ESS has an aggressive nature, whereas low-grade ESS, which was formerly called endolymphatic stromal myosis, is a slowgrowing tumor with much better prognosis[ 6 - 8 ].[ncbi.nlm.nih.gov]
  • My prognosis was about six months. I was introduced to Dr. Ed Viner, an oncologist who made all the difference.[coloncancercoalition.org]

Etiology

  • Detailed analysis of these cases, while logistically difficult, can prove useful in understanding the etiology and pathophysiology of the disease.[ncbi.nlm.nih.gov]
  • Etiology, prevention, and inhibition of endometriosis. Clin Obstet Gynecol 1980;23:875–83. PubMed Google Scholar 7. Macafee C, Greer H. Intestinal endometriosis. J Obstet Gynecol Br Emp 1960;67:539–55. Google Scholar 8. Krutzen G, Salvati E.[link.springer.com]
  • The constellation of tumors occurring at an early age among relatives of this kindred supports a genetic etiology.[insights.ovid.com]
  • The etiology of AS is rarely known and seems to be multifactorial [ 19 ]. Several endoscopic dilatation techniques can be used [ 20 ] to treat AS.[karger.com]
  • Given that this patient had undergone a laparoscopic uterine myomectomy, operative spillage of endometrial tissue and peritoneal implantation may be suggested as an etiological factor.[synapse.koreamed.org]

Epidemiology

  • Definition / general Endometriosis arising within colon Epidemiology Up to 1/3 with endometriosis have involvement of large or small intestine Sites Usually rectosigmoid or rectovaginal septum ( Med Sci Monit 2000;6:787 ); can involve any portion of colonic[pathologyoutlines.com]
  • ., of the Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany, conducted a meta-analysis of 43 observational studies, including over 4 million individuals and 68,936 cancer cases.[todayspractitioner.com]
  • According to epidemiology research published the Clinical Obstetrics and Gynecology published in 2010, 1 in 10 women suffer from endometriosis and that the disease is the third leading cause of gynecologic hospitalizations in the United States.[news-medical.net]
  • Somigliana E, Vigano P, Parazzini F, Stoppelli S, Giambattista E, Vercellini P: Association between endometriosis and cancer: a comprehensive review and a critical analysis of clinical and epidemiological evidence. Gynecol Oncol 2006;101:331–341.[karger.com]
Sex distribution
Age distribution

Pathophysiology

  • The authors report a case of obstruction of the sigmoid colon due to endometriosis and analyze the pathophysiology, diagnosis and surgical management of this disorder.[ncbi.nlm.nih.gov]
  • The first widely accepted theory regarding the pathophysiology of endometriosis was proposed by Sampson, in 1922. 10 The prevalence of intestinal endometriosis is 5.4% to 25.4%.[pelviperineology.org]

Prevention

  • Etiology, prevention, and inhibition of endometriosis. Clin Obstet Gynecol 1980;23:875–83. PubMed Google Scholar 7. Macafee C, Greer H. Intestinal endometriosis. J Obstet Gynecol Br Emp 1960;67:539–55. Google Scholar 8. Krutzen G, Salvati E.[link.springer.com]
  • Gynecological oncologists and enterocolonists can cooperate to not only prevent but detect early recommend preventive surgery.[ogscience.org]
  • […] and early detection of cervical cancer: American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer.[nccn.org]
  • SOURCE: An Active Lifestyle for Cancer Prevention Television Viewing and Time Spent Sedentary in Relation to Cancer Risk: A Meta-analysis[todayspractitioner.com]

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