Rare cause of painless lower gastrointestinal bleeding: A ca
Endometriosis is a complex disease in which abnormal uterine lining-like estrogen-dependent cells settle outside the uterine cavity. The gastrointestinal tract is the commonly affected region in extragenital endometriosis.

A 44-year-old female patient suffering from intermittent hematochezia for the past three months was presented with no medical history or any other symptoms correlating with current complaints.

Clinical examination showed the patient in good condition with a soft abdomen without evidence of tenderness or palpable mass or any sign of hemorrhoids or fissures. Initial abdominal sonography revealed a 20?×?25 mm hypoechoic change in the caecal region. Colonoscopic biopsies and histopathological examination revealed only colon mucosa with mucosal edema and an unspecific inflammatory reactive regenerative polypoid with no evidence of tumor tissue adenoma.

Intermittent hematochezia of the patient got worse in the following months without any other concurrent symptom. Laparoscopically assisted ileocecal resection with a sutured side-to-side ileoascendostomy was then performed. The patient was kept on an enhanced recovery program and was discharged on the fourth postoperative day with analgesics.

In particular, endometriosis must be considered as a gastrointestinal pathology as much as gynecological one, and the gastrointestinal surgeons and physicians should be aware of its symptoms or presentation.

International Journal of Surgery Case Reports
Source: https://doi.org/10.1016/j.ijscr.2021.106165