PMC7596015_01
CT with IV contrast. Transition point at 5 cm from the ileocecal valve (white arrowhead).
gr1.jpg
PMC7596015_01_gr1.jpg
fig0005
Abdominal CT scan with IV contrast showed small bowel diameter of 5 cm with air-fluid levels and transition point at 5 cm from the ileocecal valve (Fig. 1).
Intraoperative findings. Ileal obstruction induced by many blue-black endometriotic nodules (white arrowheads).
gr2.jpg
PMC7596015_01_gr2.jpg
fig0010
Ileal obstruction was induced by many blue-black nodules (Fig. 2).
Laparoscopic findings. Peritoneal endometriosis: typical and atypical lesions. A. Red petechial lesions. B. Blue-black nodules. C. Red flame-like lesions. D. Intestinal implants and white lesions. E. Adhesions and scarring. F. Glandular excrescence and peritoneal defects. G. Subperitoneal nodule. H. Old blood collections.
gr3.jpg
PMC7596015_01_gr3.jpg
fig0015
On the surface of the parietal and visceral peritoneum, many lesions were visualized and biopsied (Fig. 3).
Pathological examination and immunohistochemical analysis. A. Gross external surface with congestive areas and diameter variability. B. Luminal surface with stenosis and hemorrhagic patches. C. Panoramic view of colonic wall with mucosal layer without alterations, numerous prominent lymphoid follicles with germinal centers in the submucosa, dilated and congestive vessels in lamina propria, and serosal fibrosis that surrounds glandular structures (black arrowhead) (H&E, 4x). D. High-power view of the glandular structures. They are irregular, lined by columnar epithelial cells, and surrounded by endometrial stroma, smooth muscle fibers and some lymphocytes, as well as hemosiderin-laden macrophages (right lower corner) (H&E, 20x). E. Positive immunostaining for Estrogen Receptor. F. Positive immunostaining for PAX8.
gr4.jpg
PMC7596015_01_gr4.jpg
fig0020
The diagnosis of enterocolonic transmural endometriosis with serosal adhesions was established (Fig. 4).