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Case Reports
. 2022 Oct 7;9(10):e00872.
doi: 10.14309/crj.0000000000000872. eCollection 2022 Oct.

Intestinal Endometriosis Leading to Recurrent Hematochezia

Marta Arjonilla  1 , Amrin Khander  2 , Timothy Pal  3 , Daniel Jamorabo  4
Affiliations
Case Reports

Intestinal Endometriosis Leading to Recurrent Hematochezia

Marta Arjonilla et al. ACG Case Rep J. .

Abstract

Endometriosis occurs when endometrial tissue existing outside of the endometrial cavity has an inflammatory response, which can lead to swelling and scarring, generally in the abdominopelvic cavity. It commonly presents in reproductive-age women and very infrequently presents in postmenopausal women. We report a case of a 51-year-old woman who underwent a hysterectomy a decade before presentation with new-onset intermittent proctalgia and hematochezia. Her colonoscopy showed a sigmoid polyp, which was confirmed to be endometriosis on histopathology. This case highlights intestinal endometriosis as a rare differential to be considered in women, regardless of age, with abnormal rectal bleeding.

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Figures

Figure 1.
Figure 1.
Colonoscopic view of a hypervascular lesion embedded at the sigmoid colon luminal wall.
Figure 2.
Figure 2.
Hematoxylin and eosin images showing well-circumscribed foci of small glands dispersed in a variably cellular stroma within benign colonic mucosa.
Figure 3.
Figure 3.
Immunohistochemical stain (brown chromogen) for CD10 expression highlights the cytoplasm of stromal cells as endometrial type stroma. The stain for CD10 delineates a clear demarcation between the endometriosis and the colonic lamina propria.
Figure 4.
Figure 4.
By contrast, CDX2 stains benign colonic glands. Annotated, the negative endometrial gland (arrow).
Figure 5.
Figure 5.
Proposed algorithm for gastroenterologist when endometriosis is diagnosed through colonoscopy. FSH, follicle-stimulating hormone.
See this image and copyright information in PMC

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