Pisanu A, Deplano D, Angioni S, Ambu R, Uccheddu A. Rectal perforation from endometriosis in pregnancy: Case report and literature review. World J Gastroenterol 2010; 16(5): 648-651 [PMID: 20128037 DOI: 10.3748/wjg.v16.i5.648]
Corresponding Author of This Article
Dr. Adolfo Pisanu, Department of Surgery, Clinica Chirurgica, University of Cagliari, Ospedale San Giovanni di Dio, Via Ospedale 46, 09124, Cagliari, Italy. adolfo.pisanu@unica.it
Article-Type of This Article
Case Report
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Adolfo Pisanu, Daniela Deplano, Alessandro Uccheddu, Department of Surgery, Clinica Chirurgica, University of Cagliari, Ospedale San Giovanni di Dio, Via Ospedale 46, 09124, Cagliari, Italy
Stefano Angioni, Department of Obstetrics and Gynecology, University of Cagliari, Ospedale San Giovanni di Dio, Via Ospedale 46, 09124, Cagliari, Italy
Rossano Ambu, Department of Pathology, University of Cagliari, Ospedale San Giovanni di Dio, Via Ospedale 46, 09124, Cagliari, Italy
Author contributions: Pisanu A was responsible for the study conception and design, manuscript writing, drafting the article and revising for intellectual content; Deplano D carried out data acquisition, and manuscript writing and revising for intellectual content; Angioni A and Ambu R revised the manuscript for intellectual content and performed supportive work; Uccheddu A revised the manuscript for important intellectual content.
Supported by A grant from the University of Cagliari, Italy
Correspondence to: Dr. Adolfo Pisanu, Department of Surgery, Clinica Chirurgica, University of Cagliari, Ospedale San Giovanni di Dio, Via Ospedale 46, 09124, Cagliari, Italy. adolfo.pisanu@unica.it
Telephone: +39-70-6092420 Fax: +39-70-6092417
Received: October 16, 2009 Revised: November 16, 2009 Accepted: November 23, 2009 Published online: February 7, 2010
Abstract
This case report describes a woman with spontaneous rectal perforation from decidualized endometriosis in pregnancy. A 37-year-old woman was admitted to our hospital at 30 wk of pregnancy with symptoms suggestive of pyelonephritis, which persisted until 33 wk of gestation when delivery of a premature male baby was performed through a cesarean section. On postoperative day 2, an abdominal computed tomography showed free air in the peritoneal cavity and a pelvic abscess. Explorative celiotomy revealed a diffuse severe fecaloid peritonitis that originated from a 3-cm wide rectal perforation. A Hartmann operation was then performed. Histopathological findings were consistent with decidualization of the rectal wall. Only 20 cases of intestinal perforation due to endometriosis have been reported in the literature. This report is believed to be the first case of spontaneous rectal perforation from endometriosis in pregnancy, and it shows the potential occurrence of serious and unexpected complications of the disease.
