Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Paper Dig Surg 2009;26:50–55 DOI: 10.1159/000194197 Surgical Outcome and Long-Term Follow-Up after Segmental Colorectal Resection in Women with a Complete Obstruction of the Rectosigmoid due to Endometriosis M.J.H. de Jong a V. Mijatovic b J.H.T.M. van Waesberghe c M.A. Cuesta a P.G.A. Hompes b Departments of a Gastrointestinal Surgery, b Reproductive Medicine, and c Radiology/MR Imaging, Endometriosis Center VUMC, VU University Medical Center, Amsterdam, The Netherlands nostic tool used was magnetic resonance imaging which demonstrated in all patients multiorgan endometriosis with complete obstruction of the rectosigmoid. Thereafter, all patients underwent a segmental colorectal resection by re-laparotomy. The diagnosis intestinal endometriosis was histologically confirmed in all cases. After surgery no ma- jor complications occurred. During a follow-up of 18–36 months, residual symptoms such as chronic constipation, deep dyspareunia and chronic pelvic pain were reported in 2 patients. No recurrences of intestinal endometriosis oc- curred. Conclusion: In our case series, segmental colorectal resection showed a favorable surgical outcome with no ma- jor complications. In the long-term follow-up, a limited num- ber of residual symptoms were reported and no recurrences occurred. Intestinal endometriosis as a cause of bowel ob- struction is often a diagnostic challenge mimicking a broad spectrum of diseases. It should be included in the differen- tial diagnosis in women of reproductive age presenting with any symptoms of bowel obstruction. Magnetic resonance imaging is recommended as the primary imaging technique in such cases. In our opinion, these patients should be treat- ed in a multidisciplinary setting. Copyright © 2009 S. Karger AG, Basel Key Words Bowel obstruction  Colorectal endometriosis  Colorectal surgery  Laparotomy  Magnetic resonance imaging Abstract Introduction: Intestinal involvement is reported in up to 12% of women with endometriosis. Complete large bowel obstruction is a rare complication of intestinal endometri- osis. It is estimated to occur in less than 1% of the cases. Ob- jective: The aim of this study is to evaluate the surgical out- come and long-term follow-up after segmental colorectal resection in women with a complete obstruction of the rec- tosigmoid due to endometriosis. In addition, the diagnostic work-up is described and discussed in view of the current literature. Patients and Methods: We present a case series of 5 patients with a complete obstruction of the rectosig- moid due to endometriosis who were finally treated in our hospital within a multidisciplinary endometriosis team. We retrospectively analyzed all patients with this condition who were referred in the period January 2000 to December 2006. Results: All patients (mean age 31.8 years, range 25–43 years) underwent emergency surgery resulting in a diverting co- lostomy before referral to our hospital. The principal diag- Received: January 11, 2008 Accepted: July 9, 2008 Published online: January 21, 2009 V. Mijatovic, MD, PhD Department of Reproductive Medicine, VU University Medical Center De Boelelaan 1117 NL–1081 HV Amsterdam (The Netherlands) Tel. +31 20 444 4444, Fax +31 20 444 4811, E-Mail mijatovic@vumc.nl © 2009 S. Karger AG, Basel 0253–4886/09/0261–0050$26.00/0 Accessible online at: www.karger.com/dsu