Rectosigmoid Perforation and Sepsis from Endometriosis in Early Pregnancy

Abstract

Abstract Background: We report diagnosis and management of complicated intra-abdominal infection secondary to rectosigmoid perforation from endometriosis in early pregnancy. Case Presentation: A 30-year-old primigravid Caucasian female with abdominal pain at 15 wks gestation was found to have a massive intra-abdominal infection on laparoscopy. Initial conservative management in light of a highly desired pregnancy failed, and she required bowel diversion because of rectosigmoid perforation at a site of deep endometriosis. Post-operative course was complicated by loss of the pregnancy and multiple percutaneous drainage procedures. Conclusion: Bowel perforation as cause of acute abdomen in the setting of endometriosis should be considered in early pregnancy. With a pre-viable fetus, all measures must be taken to save the mother and definitive treatment may require bowel diversion or resection.