Perforation of the sigmoid colon during pregnancy: A rare complication of endometriosis

Perforation of the sigmoid colon in a 28-year-old woman during the 35th wee k of pregnancy is reported. The patient was admitted for crampy lower abdom inal pain, and fetal distress observed on cardiotocography led to the decis ion of an emergency cesarean section. At laparotomy the sigmoid colon was f ound to be covered by a green, fibropurulent exudate, and a small area of p erforation was found. At pathologic examination there was almost complete r eplacement of the bowel wall by endometriotic tissue, showing extensive dec idualization of its stroma. Although obviously rare, perforation of the sig moid colon due to endometriosis should be considered in the differential di agnosis of an acute condition of the abdomen during pregnancy.