Clinical Endoscopy

An Extremely Rare Case of Gastric Subepithelial Tumor: Gastric Endometriosis: Jong Kun Ha, Cheol Woong Choi, Hyung Wook Kim, Dae Hwan Kang, Su Bum Park, Su Jin Kim, Jeong Beom Hong; Clin Endosc 2015;48(1):74-77. Published online January 31, 2015; DOI: https://doi.org/10.5946/ce.2015.48.1.74

Endometriosis is a disease characterized by the presence of endometrial tissue outside of the uterine cavity. It is common in women of childbearing age, and is most frequently located in the pelvic cavity. Approximately 10% of endometriosis cases occur outside of the pelvic cavity in locations such as the intestines, genitourinary system, kidneys, lungs, and skin. However, there have been few reports of endometriosis in the stomach. Here, we report a rare case of endometriosis that presented as a subepithelial stomach tumor.

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Gastric Endometriosis
Bendeguz Metz, Yael Tovia, Dimitrios R. Kalaitzopoulos, Nicolas Samartzis
Journal of Minimally Invasive Gynecology.2024; 31(8): 633. CrossRef
Müllerian‐type carcinosarcoma arising in gastric endometriosis: Case report and review of the literature
Rayne Peerenboom, Sabrina Wang, Ryan Morgan, Seth Sankary, Lindsay Yassan, Katherine Kurnit, Mitchell C. Posner
Clinical Case Reports.2024;[Epub] CrossRef
Gastric wall endometriosis: A case report
Meng Chieh Chou
Tungs' Medical Journal.2024; 18(2): 121. CrossRef
Transcoelomic and Lympho-Hematogenous Dissemination of Endometrioid Heterotopias – the Mechanism of Extragenital Endometriosis Formation
R. V. Ukrainets, Yu. S. Korneva
Journal of Anatomy and Histopathology.2021; 10(1): 85. CrossRef
Molecular and Cellular Changes in the Pathogenesis of Endometriosis
K. A. Toniyan, O. I. Orlov, V. V. Boyarintsev, I. V. Ogneva
Human Physiology.2021; 47(6): 690. CrossRef
Imaging of gastrointestinal endometriosis: what the radiologist should know
Adrian Jaramillo-Cardoso, Anuradha S. Shenoy-Bhangle, Wendaline M. VanBuren, Giancarlo Schiappacasse, Christine O. Menias, Koenraad J. Mortele
Abdominal Radiology.2020; 45(6): 1694. CrossRef

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A Case of Endometriosis with Chylous Ascites: Yoon Jung Lee, M.D., Young Cheol Jo, M.D., Tae Hoon Jang, M.D., Bon Ho Ku, M.D., Chi Hoon Kim, M.D., Hye Yon Park, M.D., Kwang Hyuk Lee, M.D. and Jeong Won Lee, M.D.*; Korean J Gastrointest Endosc 2010;41(6):368-372. Published online December 30, 2010

Abstract PDF: Chylous ascites is the extravasation into the peritoneal cavity of milky chyle that is rich in triglycerides. Sixty to seventy percent of chylous ascites cases are caused by cirrhotic liver disease, congestive heart failure, or malignancy. The most common malignancy associated with chylous ascites is lymphoma. Rarely, tuberculosis has been reported as a cause of chylous ascites. Appropriately, lymphoma, ovarian cancer or tuberculosis is considered first in the differential diagnosis when a young woman of reproductive age presents with chylous ascites. Recently, we examined a 26-year-old woman who visited our hospital because of abdominal distension. Ascites tapping, esophagogastroduodenoscopy, colonoscopy and diagnostic laparoscopic biopsy led to a diagnosis of intraperitoneal endometriosis with chylous ascites. To date, some cases of endometriosis complicated by massive ascites have been reported. However, endometriosis complicated by chylous ascites has not been previously reported. The case was successfully treated using a gonadotropin-releasing hormone agonist and diuretics. (Korean J Gastrointest Endosc 2010;41:368-372)

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Rectal Endometriosis That Is Difficult to Differentiate from Endoscopically Resectable Subepitherial Lesion: Seung Kyu Chung, M.D., Suck-Ho Lee, M.D., Bum Suk Son, M.D., Chang Kyun Lee, M.D., Tae Hoon Lee, M.D., Il-Kwun Chung, M.D., Sun-Joo Kim, M.D. and Ji-Hye Lee, M.D.*; Korean J Gastrointest Endosc 2010;41(5):319-323. Published online November 30, 2010

Abstract PDF: Endometriosis occurs most frequently in the intestine. In the pelvic organs intestinal endometriosis presents with various symptoms and endoscopic findings. If an asymptomatic submucosal lesion is found in the sigmoid colon or rectum of reproductive women, a differential diagnosis should be done. Owing to advancements in endoscopic therapy, endoscopic excision has been attempted for various subepithelial lesions. To successfully do an endoscopic excision, accurate diagnosis should be obtained through diagnostic tests such as endoscopic ultrasonography prior to excision. Here the authors report a case of rectal endometriosis in an asymptomatic woman of reproductive age. They attempted endoscopic resection based on the endoscopic finding that the subepithelial lesion was limited to the submucosal layer in endoscopic ultrasonography. This conclusion turned out to be a mistaken one. Because of tumor adhesion to the proper muscular layer, we failed to successfully conduct an endoscopic excision. Ultimately, we did surgery and diagnosed rectal endometriosis. (Korean J Gastrointest Endosc 2010;41:319-323)

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Rectal Polypoid Endometriosis Mimicking Malignant Rectal Tumor: Eun Sun Kim, M.D., Yoon Tae Jeen, M.D., Donghun Lee, M.D., Young Jin Kim, M.D., Jae Youn Park, M.D., Jin Nam Kim, M.D., Sanghoon Park, M.D., Bora Keum, M.D., Young Jig Cho, M.D., Hwi Kong, M.D., Chang Don Kang, M.D.*, Yong Sik Kim, M.D., Hoon Jai Chun, M.; Korean J Gastrointest Endosc 2007;34(3):156-160. Published online March 30, 2007

Abstract PDF: Endometriosis is a disorder that presents as endometrial glands and stroma outside the uterine cavity and its musculature. It is a common gynecologic disease affecting approximately 15% of fertile women. However, polypoid endometriosis is rare. Our patient visited the hospital due to bowel habit changes and bloody stools. The colonoscopy revealed a large ulcerating polypoid mass in the rectum. Image studies including CT scan, MRI, and PET-CT suggested rectal cancer but the biopsy was negative for a malignancy. Finally, she was diagnosed with rectal polypoid endometriosis by a surgical rectal mass resection. We report a case of rectal polypoid endometriosis mimicking a rectal polypoid cancer. (Korean J Gastrointest Endosc 2007;34:156⁣160)

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Mucocele of the Appendix Secondary to Obstruction by Cecal Endometriosis: Hyun-Min Lim, M.D. and Won-Choong Choi, M.D.; Korean J Gastrointest Endosc 2007;34(2):111-114. Published online March 2, 2007

Abstract PDF: The mucocele of the appendix is an uncommon abnormality caused by a dilatation of the appendiceal lumen caused by the abnormal accumulation of mucus. It can be associated with other colorectal tumors. Endometriosis of the gastrointestinal tract is also rare, particularly in the cecum. An appendiceal mucocele is usually diagnosed by a radiological study or surgery, however, recently, a colonoscopy is becoming an important diagnostic tool for colon diseases. We report a case of appendiceal mucocele. It is believed that the condition developed as a result of an obstruction of the appendicecal lumen caused by endometriosis, and might have been the cause of the intermittent right lower quadrant pain experience by the patient, which was aggravated during the menstrual period.

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A Case of Endometriosis Presenting as Constipation: Sang Hyen Joo, M.D., Woo Jin Jeong, M.D., Jeong Soo Kim, M.D., Won Il Park, M.D., Gwang Ha Kim, M.D., Jeong Heo, M.D., Dae Hwan Kang, M.D., Geun Am Song, M.D., Mong Cho, M.D., Suk Kim, M.D.* and Do Youn Park, M.D.^†; Korean J Gastrointest Endosc 2004;29(6):534-538. Published online December 30, 2004

Abstract PDF: Endometriosis is the abnormal growth of endometrial tissue outside of uterine cavity. The incidence of endometriosis is estimated about 8∼15% of the reproductive women. The intestinal invasion is showed at about 3∼34%. The intestinal invasion may be involved in rectosigmoid colon, appedix, ileum, and cecum in order of decreasing frequency. Until now, only 7 cases have been reported in Korea. Most cases are diagnosed after surgery. And then the diagnosis need to be confirmed by surgical pathology. Recently, a 42 year-old woman visited due to severe constipation. A flexible sigmoidoscopy revealed submucosal tumor on rectosigmoidal juction 20 cm above the anal verge. The surgical resection was performed and the biopsy showed the endomtriosis involving mucosa, submucosa, muscularis, serosa, subserosa and lymph node. (Korean J Gastrointest Endosc 2004;29:534⁣538)

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구연 / 포스터 : Sigmoid Endometriosis: Korean J Gastrointest Endosc 2001;22(5):368-368. Published online November 30, 2000

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과산화수소에 의해 유발된 대장염 1예 ( A Case of Hydrogen Peroxide Induced Colitis ): Korean J Gastrointest Endosc 1999;19(4):659-667. Published online November 30, 1998

Abstract PDF: Endometriosis is the abnormal growth of endometrial tissue outside the uterine cavity. Involvement of the gastrointestinal tract is seen in 3∼34% of patients affected by this condition. Although the commonest sites involved are the sigmoid colon and rectum, only 4 cases have been reported in Korea. The most frequent symptoms are lower abdominal and pelvic pain typically worsening at the time of menstruation. Bleeding per rectum is uncommon since the mucosa is rarely involved. Endoscopy has not been thought to be helpful in the evaluation of patients with suspected colonic endometriosis. However, endoscopy is often used as the first test in patients with rectal bleeding, excluding malignancy or other sources of bleeding. There are few reports of endoscopic documentation of colorectal endometriosis. A 26 year-old woman having a history of endometriosis with cyclic hematochezia and lower abdominal pain is herein reported. A flexible sigmoidoscopy revealed a protrusion of hyperemic mucosa with a surrounding fold formation on the rectum 8 cm above the anal verge. The subsequent biopsy of the lesion gave rise to a diagnosis of endometriosis. (Korean J Gastrointest Endosc 19: 667∼670, 1999)

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증례 : 내시경하 조직검사상 진단된 직장내 자궁내막증 1예 ( Case Reports : A Case of Rectal Endometriosis Which is Confirmed Colonoscopic Biopsy ): Korean J Gastrointest Endosc 1995;15(2):303-309. Published online November 30, 1994

Abstract PDF: Endometriosis of the rectum is unusual condition, since it represents an invasion of previously normal bowel by hormone-dependent nonmalignant cell from uterus of the same patient. It is estimated that the incidence of endometriosis is about 8-15% of reproductive women, of whom 3-34% show intestinal invasion of rectosigmoid colon, appendix, ileum, and cecum in order of decreasing frequency. Symptoms related bowel involvement may vary from none to complete intestinal obstruction. Because the mucosa is involved infrequently there is rarely rectal bleeding. X-ray and sigmoidoscopic studies are usually negative. It was not reported that colonic endometriosis was confirmed by endoscopic biopsy. Recently we experienced a case of rectal endometriosis which presented itself as a cyclic rectal bleeding with abdominal pain and diagnosed by colonoscopic biopsy.

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