Asian Journal of Research and Reports in Gastroenterology

A Distinctly Rare Cause of Haemafecia: Recto-Sigmoid Endometriosis

Shishirendu Parihar

Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Aakash Shah

Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Nitesh Bassi

Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Ishan Mittal

Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Chandrika Gupta

Dr. Lal Path Labs, Varanasi, Uttar Pradesh, India.

Anurag K. Tiwari

Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Vinod Kumar

Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Sunit Shukla

Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

V. K. Dixit

Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

D. P. Yadav *

Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

*Author to whom correspondence should be addressed.

---

Abstract

Endometriosis is defined as the growth of functional endometriotic gland and stroma outside the uterine cavity. Although it is common in women of reproductive age (10-12% of menstruating females), extra genital endometriosis is considerably rare. Bowel involvement is estimated to occur in 5%–12% with the recto-sigmoid region involved in up to 90% of these cases. Recto-sigmoid endometriosis may manifest with abdominal pain, constipation, and rectal bleeding. For diagnosis radiological investigations like Transvaginal ultrasound and MRI pelvis are widely used, endoscopic biopsy is less rewarding, however surgically resected specimen provides appropriate tissue for diagnosis. The management consists of hormonal therapy including Oral Contraceptive pills, Gonadotrophin releasing hormone analogue and surgical resection of affected segments. Hence recto sigmoid endometriosis can present as a rare etiology of haematochezia. We present the case of a 25-year-old Caucasian female patient with recto-sigmoid endometriosis.

Keywords: Endometriosis, haemafecia, lower gastrointestinal bleeding, recto-sigmoid colon, laparoscopic excision

---

---