Postpartum caecal perforation due to endometriosis

Abstract

The prevalence of endometriosis in women in the general population is in the region of 10% and it most commonly occurs in the pouch of Douglas, pelvic peritoneum and ovaries. However, extra-genital sites such as the small and large intestine can be involved. Extra-uterine endometrial tissue behaves just as uterine endometrial tissue and, therefore, undergoes hormone-induced changes during the menstrual cycle including bleeding. The clinical consequence of this is severe pain, which is the commonest presentation of endometriosis.1 During pregnancy the endometrial stroma undergoes decidualisation due to hormonal changes and the normally small cells of the endometrial stroma undergo enlargement. Ectopic endometrial tissue also undergoes decidualisation.2,3