Intestinal and pelvic endometriosis: psychological and surgical considerations

Endometriosis occurs in women of reproductive age and is most commonly found on the peritoneal surface of the reproductive organs. The prevalence of the disease in the general population ranges between 1 and 8% according to different series.1 The intestine is affected in less than 20% of patients suffering from gynaecological endometriosis. In the rectosigmoid colon, endometriosis may mimic either a neoplasm or inflammatory bowel disease and may even cause intestinal obstruction. Nearly half of the patients with endometriosis suffer from infertility due to hormonal defects. The hormonal treatment of the disease prevents pregnancy. This problem, together with symptoms, such as severe pelvic pain, may affect the patient’s quality of life and cause mental illness. The aim of this paper is to report a case of large bowel endometriosis unusually affecting the entire circumference of the rectum and causing anxiety and depression. Major surgery and psychotherapy were needed to successfully treat the patient.