Small bowel obstruction secondary to ileal endometriosis: multisection computer tomography evaluation.

Approximately 10 to 15% of pre-menopausal women are affected by endometriosis, which in rare cases can cause intestinal obstruction (1). The presence of ectopic endometriotic tissue in the loops of the small bowel affects the serosa (visceral peritoneum) and muscularis propria, but never penetrates the mucosa (2). Fibrosis and secondary adhesions are the major causes of obstruction (2). Ileal involvement is uncommon and usually affects the terminal ileum within 10 cm of the ileocecal valve (3). Intestinal endometriosis should be suspected in cases of young nulliparous women with abdominal or pelvic pain (3,4). Imaging diagnosis is difficult. However, multisection computer tomography (CT) provides high spatial resolution and multiplanar reformation images, which can be very demonstrative and characteristic.