Ileal endometriosis and Crohn's disease: an unusual association causing acute bowel obstruction

AIM: Endometriosis is a commun health disorder in women, which is defined as the presence of bowel endometrial-like tissue outside the uterus. Bowel endometriosis occurs in approximately10% pf all cases, with ileal localization as a very rare clinical intestinal occlusion:acute intestinal obstruction is possible presentation of this disease. We report a case of a patient with known history of Crohn's treated with ileal resection for acute intestinal occlusion;histology showed the coexistence of IBD and endometriosis in the intestinal wall. CASE REPORT: A 35 years old female patient, with previous diagnosis of Crohn's disease confirmed by endoscopic biopsies, was admitted to our Institutions because oc acute intestinal obstruction. She previously suffered of dysmenorrhea and pelvic pain during menstration. A contrast enhanced CT abdominal scan was performed with evidence of diffuse small bowel fluid distension and thickening of terminal iileum wall, compatible with ilea stenosis in acute Crohn disease. RESULTS: The patient underwent laparoscopic resection of distal ileus. Definitive histological examination showed ileal wall with multiple endometriosis foci and chronic follicular flogosis. CONCLUSION: The case that we have described shows a rare co-existence of the two clinical entitle (Crohn's disease and ileal deep endometriosis), histologically demonstrated, with acute presentation as intestinal obstruction, susseflully treated with laparoscopic ileal resection KEY WORDS Bowel obstruction, Crohn's disease, Endometriosis.