Rectosigmoid Endometriosis: A Rare Cause of Haemafacia

The present study reports a case of a young female presenting with haemafecia during menstruation. The development of a functional endometriotic gland and stroma outside of the uterus is known as endometriosis. Even though it affects 10-12% of women who are in menstruation and are of reproductive age, extra-genital endometriosis is quite uncommon. Bowel involvement is estimated to occur in 5%–12% with the recto-sigmoid region involved in up to 90% of these cases. We report a case of a 25-year-old female patient who presented to Gastrointestinal OPD with complaints of recurrent episodes of hematochezia with moderate left lumbar and hypogastric region pain during menses for the last 5 years. Recto-sigmoid endometriosis may manifest with abdominal pain, constipation, and rectal bleeding. For diagnosis radiological investigations like Transvaginal ultrasound and MRI pelvis are widely used, and endoscopic biopsy is less rewarding, however surgically resected specimen provides appropriate tissue for diagnosis. The management consists of hormonal therapy including Oral Contraceptive pills, gonadotrophin releasing hormone analogue and surgical resection of affected segments. This cause should always kept in mind while evaluating a young reproductive age group female with bleeding per rectum.