Endometriosis is an estrogen-dependent disease that affects 5 to 10% of women of reproductive age in the United States
]. Its defining feature is the presence of ectopic endometrial tissue. The main clinical features are chronic pelvic pain, pain during intercourse, and infertility. Endometriosis can be the result of diverse anatomical or biochemical aberrations of uterine function. The pathogenesis of endometriosis is still unknown. The gold standard for diagnosis of pelvic disease is surgical assessment
Endometriosis has been more likely described in pelvic organs (ovaries, fallopian tubes, uterosacral ligaments, Douglas Pouch). It has been described in every part of the body (heart, lung, kidney, gastrointestinal tract, diaphragm, legs, bone, incisional scar, ombilicus, liver),
] except the spleen
Intussusception is defined as the telescoping of a segment of the gastrointestinal tract into an adjacent one. Intussusception is uncommon in adults compared with the pediatric population. It is estimated that only 5% of all intussusceptions occur in adults and approximately 5% of bowel obstructions in adults are the result of intussusception
]. Leon K. shows in an institutional review of intussusception in adults a pathologic cause identified in 85% of patients with 8 of 22 (36%) small bowel and 4 of 5 (80%) of large bowel lesions being malignant. All small bowel cancers represented metastatic disease and all large bowel malignancies were primary adenocarcinomas
]. Prystowsky JB shows 1573 consecutive patients with endometriosis diagnosed at laparoscopy or laparotomy, 85 patients (5.4%) had gastrointestinal involvement
]. Frequently, intestinal localisations of endometriosis are the rectum or the sigmoid, and more rarely appendix, ileum, and right colon
In the literature, only six cases of ileocolic intussusceptions due to a cecal endometriosis were reported
]. We report the seventh case. Aronchick et al.
], the first case, report a clinical presentation of ileocolic intussusception and digestive hemorrhage. Twenty years later, Denève et al.
] report the case of a 43-year-old woman, who presented a complete and non-reductible ileo-cecal intussusception with occlusion. Le Meaux et al.
] report a 40-years-old woman who had an ileo-caeco-colic intussusception on a digestive endometriosis. Koutsourelakiss et al.
] report a 32-year-old nulliparous Caucasian woman who presented to the emergency department for abdominal pain, distension with nausea and vomiting corresponding to a cecal endometriosis. Maltz et al.
], show a lesion, with the appearance of inflammatory (Crohn's disease) or infectious (tuberculosis). Indraccolo et al.
] report a patient who presented an ileocolic intussusception with right iliac fossa pain, distension and diarrhea coverage for laparoscopic debulking of severe endometriosis. In this case, we report another unusual presentation of endometriosis characterized by ileo-cecal intussusception.
The diagnosis of endometriosis may be suspected on the basis of the clinical history. Computed tomography is not the primary imaging for evaluation of digestive endometriosis. However, multislice computed tomography enteroclysis identifies 94.8% of bowel endometriotic nodules
], and magnetic resonance imaging has a high sensitivity (77%-93%) in the diagnosis of bowel endometriosis
CA-125 is the principal serum marker used in the diagnosis and management of late-stage endometriosis. Cancer antigen CA-125 has been used to monitor the progress of endometriosis
Surgical treatment is indicated for pain, bleeding, and intestinal obstruction. The treatment of small bowel endometriosis is surgical resection of the involved segment, while medical therapy is only a temporary treatment