Endometriosis as a cause of colonic obstruction.

Case Report A 41-year-old woman with a family history of colon cancer in her father complained to her family physician of a 4-month history of crampy lower abdominal pain and a change of bowel habits from regularity to intermittent constipation and loose stools. There was no particular pattern to the bowel movements, and she could not recall what would aggravate the pain, but having a bowel movement provided temporary relief. The stool had not changed in color or odor and did not appear bloody or tarry. She had no fever, chills, night sweats, anorexia, weight loss, nausea, or vomiting. Her menstrual periods were irregular and were accompanied by cramps and heavy flow. She did have a recent travel history to an area once endemic to Giardia lamblia; however, no one else in her travel party had any symptoms. She did not eat any new or unusual foods. She had a medical history notable for a Clark level I melanoma, fibrocystic breast disease, a benign thyroid adenoma, hypothyroidism, and dysfunctional uterine bleeding. A recent work-up for her dysfunctional uterine bleeding included a Papanicolaou smear and endometrial biopsy, the results of which were normal. Leiomyomas, suspected on pelvic examination, were confirmed by sonography, and magnetic resonance imaging obtained in response to a mildly elevated CA 125 revealed normal ovaries. Findings on a hysterosalpingogram to assess infertility were also normal. Past surgery included excisional biopsies of the melanoma and breast