Chronic intestinal obstruction due to rectosigmoid endometriosis: a case report

Abstract

Intestinal endometriosis is not commonly reported in Nigeria and Africa. This paper presents a case of chronic intestinal endometriosis in a young Nigerian woman presenting with features of chronic intestinal obstruction. The case records of a 29-year old Nigerian female, who presented with chronic intestinal obstruction secondary to endometriosis at the Olabisi Onabanjo University Teaching Hospital (OOUTH) Sagamu, Nigeria and literature review on the subject using medline and manual library search is presented. A young woman presented with a three- month history of progressive abdominal distension and worsening constipation. Examination revealed a grossly distended abdomen, slightly tense but no area of tenderness. Bowel sounds were slightly exaggerated. A plain radiograph of the abdomen showed features of small and large bowel obstruction. A diagnosis of chronic large bowel obstruction was made. She was found to have a stricture in the rectosigmoid at laparotomy. Hartmann's resection was done. Histologically, the stricture was due to endometriosis. Subsequent closure of colostomy and re-establishment of intestinal continuity gave excellent results. A young Nigerian female diagnosed with chronic intestinal obstruction due to rectosigmoid endometriosis was successfully treated. Though this condition is believed to be relatively uncommon in Nigeria, there is a need for a high index of suspicion, to ensure early diagnosis.