Case Report

Intestinal and pelvic endometriosis: psychological and surgical considerations

  • VLASTA PODZEMNY
  • VERONICA MONICA CIOLI
  • HECTOR TAPIA
  • MOHAMMED NEMATI FARD
  • MARIO PESCATORI

Pelviperineology 2009;28(1):14-16

Bowel endometriosis is an uncommon disease that can provoke severe symptoms including intestinal obstruction. The disease generally affects young women, and, often has psychological implications since it is associated with severe pain and infertility. Our patient, a 40-year-old woman, suffered from rectal bleeding, dysmennorrhea, and episodes of intestinal obstruction, as well as anxiety and depression documented by various psychological tests. Surgery revealed a tumor-like mass below the rectosigmoid junction and endometriotic nodules on the right ovary and ileum. The rectosigmoid colon was resected and the nodules removed. The patient, who had an uneventful postoperative course, is currently in good physical condition but is still depressed and receiving hormonal therapy and psychotherapy. A combined surgicalpsychological- hormonal approach may be the most effective way to treat intestinal and pelvic endometriosis.

Keywords: Endometriosis; Rectosigmoid colon; Intestinal resection; Ovarian cyst; Psychological evaluation; Trait and state anxiety; Drawing tests.