Can intestinal endometriosis cause a bowel obstruction during pregnancy?

Details

This single-patient case report describes endometriosis of the ileum presenting with intussusception in early pregnancy. A 35-year-old woman came to the hospital with abdominal pain, vomiting and diarrhea. A mass was felt in her lower abdomen. Abdominal ultrasonography and CT showed a target-like appearance. She was diagnosed with intestinal obstruction due to intussusception and underwent emergency surgery.

During surgery, a tumor was found 70 cm from the end of the ileum, and a portion of the ileum was removed. The removed specimen showed a small red cyst on the slightly depressed serosa and a submucosal tumor beneath the smooth mucosa. Histopathological examination diagnosed ileal endometriosis and confirmed secretion from the endometrial glands and decidualization of the stroma, consistent with features of early pregnancy.

The authors considered this a very rare case of ileal endometriosis causing intussusception during pregnancy. They stated that no protective effect of pregnancy against intestinal endometriosis was observed, and suggested that the disease might respond poorly to hormone therapy and require surgical resection when structural hardening and scar-related narrowing are pronounced.