title: Postmenopausal intestinal obstructive endometriosis: case report and review of the literature.
abstract: BACKGROUND
  Endometriosis is characterized by the presence of endometrial tissue outside the uterine cavity, which is commonly detected in gynecological practice but rarely reported as a coloproctological disorder. The objective of the present report was to discuss a rare case of postmenopausal intestinal endometriosis simulating a malignant lesion, following a review of the literature.
  
  
  METHODS
  A 74-year-old woman with complaints of hematochezia and tenesmus of two months' duration accompanied by liquid feces and pelvic pain, but with no other gastrointestinal or gynecological complaints, was referred to our service. She had been menopausal for 22 years, with no hormone replacement treatment, and had undergone panhysterectomy three years before the referral to us, due to endometrial thickening and a right adnexal cyst. Five months before this referral, she had undergone laparotomy due to acute obstructive abdomen, which revealed a tumor mass involving the small bowel. Anatomopathological examination of the enterectomy suggested a hypothesis of intestinal endometriosis. A proctological examination was normal. Computed tomography of the pelvis revealed thickening of the rectosigmoid transition and colonoscopy revealed friable tumor formation in the rectum. A biopsy of the lesion revealed mucosal fragments of endometrial type, which led to a review of the previous anatomopathological examination. The patient underwent rectosigmoidectomy with protective transversotomy, with a good postoperative course, and anatomical examination confirmed the intestinal endometriosis. The patient subsequently suffered a stenosing recurrence of the lesion and has undergone colostomy since then.
authors: Department of Surgery and Anatomy, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto,São Paulo, Brazil.
authors: Pedro
authors: P
authors: Popoutchi
authors: Carlos Renato
authors: CR
authors: dos Reis Lemos
authors: Julio César Rosa E
authors: JC
authors: Silva
authors: Antônio Alberto
authors: AA
authors: Nogueira
authors: Omar
authors: O
authors: Feres
authors: José Joaquim
authors: JJ
authors: Ribeiro da Rocha
mesh_terms: D000368:Aged; D003113:Colonoscopy; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery; D017698:Postmenopause; D012002:Rectal Diseases / Q000150:complications* / Q000601:surgery; D012810:Sigmoid Diseases / Q000150:complications* / Q000601:surgery