DTMT Network

A 35-year-old American woman got a new lease of life at a local Mumbai hospital after she was successfully treated for a large endometriosis nodule in the mid and upper rectum that almost resulted in occlusion, and inability to conceive.

After the successful treatment, the patient is scheduled to undergo an IVF treatment soon in the United States.

Initially, the patient, from Boston endured symptoms of severe pelvic pain, constipation, and bloating that hampered her daily activities for most of her adult life.

Even after taking medication and trying home remedies, she continued to bear the pain. When she was in India, she met Dr. Abhishek Mangeshikar, consultant laparoscopic and robotic gynaecologist, ACI Cumballa Hill Hospital, to schedule an appointment for a hysteroscopy (a procedure used to examine the inside of the womb) prior to an IVF scheduled in the US.

“The patient had a history of severely painful periods as well as severe constipation and bloating. Her ultrasound examination revealed a large endometriosis nodule in the mid and upper rectum almost resulting in occlusion. These findings were further corroborated by MRI,” Dr. Abhishek said.

He said that bowel endometriosis can be seen when tissues similar to the uterine lining grow on the bowel or intestine. It is the most common type of extra pelvic endometriosis.

Dr. Mangeshikar informed that about 12% of cases affect the rectum and sigmoid colon. In India, an estimated 25 million patients suffer from endometriosis, informed Dr. Abhishek.

He said that in this particular case delaying treatment could cause intestinal obstruction which could become a life-threatening complication because the patient would be unable to pass stools and the intestine would eventually perforate leading to severe complications such as sepsis and possibly death.

Dr. Abhishek emphasised that surgery is not only useful at improving quality of life and reducing pain but also improves fertility.

He informed that 80 % of patients treated for bowel endometriosis had successful pregnancy outcomes in the first year or two after surgery. Out of that 80%, 2/3rds conceived naturally!

The doctor further said that since she was scheduled to return to the US soon, he reached out to her US doctors with her findings.

The US doctors couldn’t take on the case due to its complexity.

After reaching out to multiple doctors in the US, she received the same answers and finally decided to extend her stay in India. She underwent surgery on July 20, 2021.

Dr. Abhishek said that an exploratory laparoscopy for excision of endometriosis with segmental resection anastomosis of the rectum was carried out to treat a frozen pelvis with excision of endometriosis and resection of the rectum which showed involvement of about 10cms of length.

The procedure lasted for seven hours, and the patient underwent surgery with minimal blood loss and was discharged on a postoperative day 7 without even a week after her surgery.