title: Small bowel obstruction due to an endometriotic ileal stricture with associated appendiceal endometriosis: A case report and systematic review of the literature.
abstract: BACKGROUND
  Endometriosis is defined as the presence of functional ectopic endometrial tissue outside the uterine cavity. It rarely involves the small bowel and obstruction due to the same is highly uncommon. Preoperative diagnosis is difficult based on clinical and radiological studies. Diagnosis can be confirmed only on histopathological examination of the surgically resected specimen.
  
  
  METHODS
  A 44 years old lady presented with repeated episodes of abdominal pain, non bilious vomiting and diarrhea. She also gave history of abdominal pain during every menstruation. She had diffuse abdominal tenderness and the computed tomography showed a concentric infective/inflammatory thickening of the distal ileum. Colonoscopy confirmed a tight distal ileal stricture After a failed trial of conservative management, she underwent a laparoscopic right hemicolectomy. The histopathological examination revealed multiple endometriotic foci in the ileum and the appendix.
  
  
  CONCLUSIONS
  Ileal endometriosis presenting as obstruction is uncommon and very few cases have been reported thus far. The symptoms are usually cyclical but may later become continuous with the progression of the disease. Preoperative diagnostic dilemma is due to the clinical and the radiological similarities to inflammatory, infective and irritable bowel diseases.
  
  
  CONCLUSIONS
  Ours is probably the first case of small bowel obstruction due to ileal and appendiceal endometriosis that was managed with laparoscopic right hemicolectomy. We highlight the preoperative diagnostic dilemma and the progression of the cyclical symptoms. Thus, endometriosis must be considered in cases of small bowel obstruction in women in the reproductive age group as a rare cause.
authors.affiliation: Department of Gastro-Intestinal Surgery, Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra west, Mumbai 400 0050, Maharashtra, India. Electronic address: drpriyankasali@gmail.com.
authors.forename: Priyanka A
authors.initials: PA
authors.lastname: Sali
authors.affiliation: Department of Gastro-Intestinal Surgery, Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra west, Mumbai 400 0050, Maharashtra, India. Electronic address: dockamalyadav@gmail.com.
authors.forename: Kamal S
authors.initials: KS
authors.lastname: Yadav
authors.affiliation: Department of Gastro-Intestinal Surgery, Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra west, Mumbai 400 0050, Maharashtra, India. Electronic address: dsshlsh@yahoo.com.
authors.forename: Gunjan S
authors.initials: GS
authors.lastname: Desai
authors.affiliation: Department of Gastro-Intestinal Surgery, Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra west, Mumbai 400 0050, Maharashtra, India. Electronic address: drbhushanbhole@yahoo.co.in.
authors.forename: Bhushan P
authors.initials: BP
authors.lastname: Bhole
authors.affiliation: Department of Pathology, Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra west, Mumbai 400 0050, Maharashtra, India. Electronic address: asha_marygeorge@yahoo.co.in.
authors.forename: Asha
authors.initials: A
authors.lastname: George
authors.affiliation: Department of Gastroenterolgy, Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra west, Mumbai 400 0050, Maharashtra, India. Electronic address: ssparikh26@gmail.com.
authors.forename: Samir S
authors.initials: SS
authors.lastname: Parikh
authors.affiliation: Department of Gastro-Intestinal Surgery, Lilavati Hospital and Research Centre, A-791, Bandra Reclamation, Bandra west, Mumbai 400 0050, Maharashtra, India. Electronic address: drhiteshmehta1011@gmail.com.
authors.forename: Hitesh S
authors.initials: HS
authors.lastname: Mehta
keywords: Appendiceal endometriosis; Ileal endometriosis; Ileal stricture; Right hemicolectomy