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Case Reports in Obstetrics and Gynecology
Volume 2014, Article ID 907150, 3 pages
Case Report

Deep Endometriosis Induced Spontaneous Colon Rectal Perforation in Pregnancy: Laparoscopy Is Advanced Tool to Confirm Diagnosis

1General Surgery Division, Ospedali Riuniti Valdichiana Senese Hospital, Montepulciano, 53040 Siena, Italy
2Obstetrics and Gynecology Division, Ospedali Riuniti Valdichiana Senese, Via Provinciale No. 5, Località Nottola, Montepulciano, 53040 Siena, Italy

Received 21 April 2014; Accepted 13 July 2014; Published 5 August 2014

Academic Editor: Stefan P. Renner

Copyright © 2014 Aurelio Costa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Endometriosis causes rare complications in pregnancy, such as obstetrical bleeding, preterm birth, spontaneous haemoperitoneum, and intestinal perforation. The prevalence of spontaneous perforation due to intestinal endometriosis is unknown in pregnancy. A recent review of the literature indicated 15 bowel complications caused by endometriosis during pregnancy or at the immediate postpartum period. The diagnosis of a bowel perforation can be difficult and in all of the cases reported necessitates an exploratory laparotomy. Anyway, in the majority of cases bowel perforation is not diagnosed during this laparotomy, and a repeat laparotomy is needed. Laparoscopy is being used increasingly in the diagnosis and operative management of acute abdomen. Laparoscopy can be a useful means of diagnosis and in addition a therapeutic tool in selected pregnant patients with abdominal pain. We report the first case of a pregnant woman with spontaneous double sigmoid and rectal perforation from decidualized endometriosis diagnosed by laparoscopy.