Intestinal
endometriosis is a benign disease characterized by ectopic growth of the endometrium and causes extensive
fibrosis and adhesions in response to repeated episodes of
bleeding and
inflammation with the menstrual cycle. We encountered a rare case of intestinal
endometriosis that caused complete rectal obstruction in a 34-year-old woman undergoing
infertility treatment. Colonoscopy showed rectal
stenosis and obstruction but no evidence of a
tumor. Bowel obstruction due to
endometriosis was diagnosed based on the history and imaging findings. Transanal
decompression was performed. Subsequent laparoscopic surgery revealed severe
inflammation around both ovaries and a
tumor-like rectal
stenosis. Similar findings were obtained in the transverse colon and terminal ileum. We performed laparoscopic low anterior resection, partial transverse colon resection, ileocecal resection, bilateral
cystectomy, and left
salpingectomy.
Infertility treatment was restarted and resulted in a successful term pregnancy. The patient remains well. Laparoscopic surgery, which has the advantage of being minimally invasive, allows for early postoperative recovery and discharge in patients with
endometriosis; furthermore, the uterus and adnexa can be preserved due to the magnifying effect of the
laparoscope. In this case, it was possible to resume
infertility treatment. Intestinal
endometriosis is a rare cause of bowel obstruction, but should be kept in mind if
intestinal obstruction occurs during
infertility treatment. Laparoscopic surgery may be useful for multiple endometriotic lesions and serve as a bridge to
infertility treatment.