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Case Reports
. 2010 Feb 7;16(5):648-51.
doi: 10.3748/wjg.v16.i5.648.

Rectal perforation from endometriosis in pregnancy: case report and literature review

Adolfo Pisanu  1 , Daniela Deplano, Stefano Angioni, Rossano Ambu, Alessandro Uccheddu
Affiliations
Case Reports

Rectal perforation from endometriosis in pregnancy: case report and literature review

Adolfo Pisanu et al. World J Gastroenterol. .

Abstract

This case report describes a woman with spontaneous rectal perforation from decidualized endometriosis in pregnancy. A 37-year-old woman was admitted to our hospital at 30 wk of pregnancy with symptoms suggestive of pyelonephritis, which persisted until 33 wk of gestation when delivery of a premature male baby was performed through a cesarean section. On postoperative day 2, an abdominal computed tomography showed free air in the peritoneal cavity and a pelvic abscess. Explorative celiotomy revealed a diffuse severe fecaloid peritonitis that originated from a 3-cm wide rectal perforation. A Hartmann operation was then performed. Histopathological findings were consistent with decidualization of the rectal wall. Only 20 cases of intestinal perforation due to endometriosis have been reported in the literature. This report is believed to be the first case of spontaneous rectal perforation from endometriosis in pregnancy, and it shows the potential occurrence of serious and unexpected complications of the disease.

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Figures

Figure 1
Figure 1
Axial computed tomography (CT) scan. A: Free air in the abdominal cavity; B: Pelvic abscess at the right side of the enlarged uterus.
Figure 2
Figure 2
The rectal wall. A: Decidualization of the rectal wall (long arrows); mucosa side of the rectal wall (short arrow) (HE, × 40); B: Decidualized endometriosis around the rectal perforation (long arrows); rectal perforation with necrosis at the peritoneal side of the rectal wall (short arrow) (HE, × 100).
See this image and copyright information in PMC

References

    1. Witz CA. Current concepts in the pathogenesis of endometriosis. Clin Obstet Gynecol. 1999;42:566–585. - PubMed
    1. Garg NK, Bagul NB, Doughan S, Rowe PH. Intestinal endometriosis--a rare cause of colonic perforation. World J Gastroenterol. 2009;15:612–614. - PMC - PubMed
    1. Decker D, König J, Wardelmann E, Richter O, Popat S, Wolff M, Hirner A, Ulrich U. Terminal ileitis with sealed perforation--a rare complication of intestinal endometriosis: case report and short review of the literature. Arch Gynecol Obstet. 2004;269:294–298. - PubMed
    1. Schweitzer KJ, van Bekkum E, de Groot CJ. Endometriosis with intestinal perforation in term pregnancy. Int J Gynaecol Obstet. 2006;93:152–153. - PubMed
    1. Nezhat CR, Berger GS, Nezhat FR, Buttram VC Jr, Nezhat CH, Barbieri RL, Polan ML, editors . Endometriosis: advanced management and surgical techniques. New York: Springer-Verlag; 1995. pp. 19–25.

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