Our Summary

This research paper is about a severe form of endometriosis, a condition where tissue similar to the lining of the uterus grows outside of the uterus. This form, known as deep endometriosis, can cause intense pain and may contribute to infertility. It’s not very common and usually identified through physical symptoms and confirmed with imaging studies.

The paper describes a case where this condition affected the sigmoid colon (a part of the large intestine) of a 42-year-old woman. She experienced severe abdominal pain and chronic constipation. A colonoscopy and a CT scan revealed a significant blockage (90% stenosis) in the early portion of her sigmoid colon and thickening of the wall of the colon near the blockage.

To treat her condition, doctors performed a robot-assisted surgical procedure called a sigmoidectomy, where they removed the affected section of her colon. Six months after her surgery, the woman had no symptoms, no signs of the disease returning, and no problem with the function of her colon.

FAQs

  1. What is deep endometriosis and how is it diagnosed?
  2. What are the symptoms of deep infiltrating endometriosis affecting the sigmoid colon?
  3. What is a robot-assisted sigmoidectomy and how effective is it in treating deep endometriosis affecting the sigmoid colon?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sigmoidectomy is to follow post-operative care instructions carefully, including taking prescribed medications, eating a healthy diet, and avoiding heavy lifting or strenuous activity for a period of time. It is also important to attend follow-up appointments with your healthcare provider to monitor your recovery and address any concerns. Being proactive in your recovery can help ensure a successful outcome after sigmoidectomy.

Suitable For

Patients with deep infiltrating endometriosis affecting the sigmoid colon are typically recommended sigmoidectomy. These patients may present with symptoms such as severe pain in the left lower quadrant and chronic constipation. Imaging studies, such as colonoscopy and computed tomography, may reveal stenosis and mural thickening in the sigmoid colon, indicating the need for surgical intervention. Robot-assisted sigmoidectomy may be performed to remove the affected portion of the colon and provide resolution of symptoms. Patients who undergo sigmoidectomy for deep infiltrating endometriosis of the sigmoid colon may experience relief of symptoms and improved quality of life with a low risk of recurrence or functional impairment.

Timeline

Before sigmoidectomy:

  • Patient experiences colicky pain in the left lower quadrant and chronic constipation
  • Colonoscopy reveals a 90% stenosis in the proximal portion of sigmoid colon
  • Mural thickening is noted proximal to the site of stenosis on computed tomography with oral contrast

After sigmoidectomy:

  • Robot-assisted sigmoidectomy is performed
  • 6-month follow-up shows patient is asymptomatic and without lesions suggestive of recurrence
  • There is no functional impairment noted in the patient

What to Ask Your Doctor

  1. What is a sigmoidectomy and why is it being recommended for me?
  2. What are the risks and potential complications associated with a sigmoidectomy?
  3. What is the recovery process like after a sigmoidectomy?
  4. Will I need to make any lifestyle changes or follow a special diet after the procedure?
  5. How long will it take for me to fully recover and resume normal activities?
  6. Will I need any additional treatments or follow-up care after the sigmoidectomy?
  7. Are there any alternative treatments or options available for my condition?
  8. Are there any long-term effects or implications of having a sigmoidectomy?
  9. How successful is a sigmoidectomy in treating deep infiltrating endometriosis affecting the sigmoid colon?
  10. Are there any specific warning signs or symptoms I should watch out for after the procedure?

Reference

Authors: Lomeli-Reyes D, Montoya-Ramírez J, Reyes-Rodríguez E, López-Almanza PX, Ochoa-Ruiz PL. Journal: J Surg Case Rep. 2023 Jun 10;2023(6):rjad342. doi: 10.1093/jscr/rjad342. eCollection 2023 Jun. PMID: 37309546