Case Report: A case of intestinal occlusion caused by endometriosis

Background: Endometriosis is a common gynecological condition, but intestinal involvement leading to bowel obstruction is rare, occurring in only 0.1-0.7% of cases. Diagnostic delay is frequent due to non-specific gastrointestinal symptoms. Case representation: A 37-year-old woman presented to the emergency department with abdominal pain and recurrent intestinal obstruction for 10 days. Initial computed tomography (CT) at another hospital showed colonic obstruction, and thus she received gastric intubation, which provided no relief. At our hospital, she underwent emergency exploration surgery, which found suspicious deep infiltrating endometriosis (DIE). After being discharged from the hospital, she attended the outpatient departments of General Surgery and Gynecology alternately, and completed auxiliary examinations. A multidisciplinary team (MDT), including gynecologists, general surgeons, ultrasound specialists, and radiologists, thoroughly and collaboratively assessed the lesion. The gynecologist decided to attempt a diagnostic treatment with gonadotropin-releasing hormone agonist (GnRHa), which finally attributed her symptoms to endometriosis. Subsequent surgery and pathological examination confirmed bowel endometriosis. The patient is now on long-term medical therapy. Conclusion: This case highlights the diagnostic challenges of bowel endometriosis presenting as intestinal obstruction, and underscores the value of MDT and a diagnostic trial of GnRHa in achieving timely diagnosis and appropriate management.