Dreigende ‘blow-out’ van het caecum door endometriose

Background

Endometrial tissue is present outside the uterine cavity in 6-10% of fertile women. Associated symptoms such as dysmenorrhoea, dyspareunia and abdominal discomfort are non-specific. For this reason, endometriosis is not always considered in women with abdominal symptoms. Endometriosis can also manifest itself as an acute surgical emergency such as an intestinal obstruction.

Case description

A 29-year-old woman was admitted to our hospital with acute lower abdominal pain and vomiting. On rectal examination a firm mass was palpable. CT scan of the abdomen showed the loops of colon to be extremely dilated. As a caecal blowout seemed imminent we carried out a laparotomy which revealed an obstruction of the rectum caused by severe endometriosis.

Conclusion

In fertile women presenting with signs of acute bowel obstruction, endometriosis should be included in the differential diagnosis and an early gynaecological consultation is indicated.

Conflict of interest and financial support: none declared.