Postmenopausal Deep Infiltrating Endometriosis of the Colon: Rare Location and Novel Medical Therapy

Author:

Snyder Benjamin M.1ORCID,Beets Joseph W.2,Lessey Bruce A.3,Horton Samuel R. W.4,Abrams Gary A.2

Affiliation:

1. University of South Carolina School of Medicine Greenville, Greenville, SC, USA

2. Department of Gastroenterology/Liver Center, Greenville Health System, University of South Carolina School of Medicine Greenville, Greenville, SC, USA

3. Department of Obstetrics and Gynecology, Greenville Health System, University of South Carolina School of Medicine Greenville, Greenville, SC, USA

4. Department of Pathology, Greenville Health System, University of South Carolina School of Medicine Greenville, Greenville, SC, USA

Abstract

We report an uncommon case of deep infiltrating endometriosis of the colon presenting as iron deficiency anemia nine years after hysterectomy with bilateral salpingo-oophorectomy. The endometrial implant was found at the hepatic flexure, an exceedingly rare location for endometriosis invasion with no cases distinctly reported in the literature. Additionally, the presentation of gastrointestinal endometriosis as iron deficiency anemia is not well documented in the literature. Instead of surgery, we prescribed a novel medical therapeutic approach using conjugated estrogen-bazedoxifene to antagonize the proliferative effects of estrogen on endometrial tissue. After five months of therapy and repeat colonoscopy, no evidence of endometrial tissue remained in the hepatic flexure.

Funder

Department of Medicine at Greenville Memorial Hospital

Publisher

Hindawi Limited

Subject

General Engineering

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