Pelviperitonitis by colorectal perforation in the third trimester of pregnancy after surgery for deep pelvic endometriosis

Objective To report a severe complication after colorectal resection for rectovaginal endometriosis. Design Case report. Setting University hospital. Patient(s) A 37-year-old patient treated with colorectal resection 3 years ago for rectovaginal endometriosis was admitted with a rectal perforation at 37 weeks’ gestation. Intervention(s) Caesarean section and simple interrupted stitch of the perforation by absorbable Vicryl. Main Outcome Measure(s) Determination of the cause of the perforation in healthy rectal tissue above the anastomosis. Result(s) The most likely mechanism was secondary colonic hyperpressure owing to stenosis of the colorectal anastomosis. Conclusion(s) Young patients planning to conceive but scheduled to undergo colorectal resection should be made aware of the significant complication rate associated with this procedure and the promising results of nodule excisions. We recommend close monitoring of patients suffering from chronic constipation after resection for rectosigmoid endometriosis.