[Transmural rectal endometriosis as a cause of chronic constipation. A case report and literature review]. / Endometriosis transmural rectal como causa de estreñimiento crónico. Reporte de un caso y revisión de la bibliografía.

The incidence of intestinal endometriosis is reported between 5.3 and 12% of cases and of these, between 70 and 93% are located in the rectum and sigmoid. We report the case of a 32-year-old with constipation and bloating and cramping pain during the last 2 years. The pain increased in frequency during the past 6 months. From the data obtained from physical examination and imaging studies may be suspected pelvic endometriosis with infiltration of anterior rectal wall. Resection of the low anterior rectum with colo-rectal anastomosis was performed, with adequate surgical outcome and resolution of symptoms. In patients of childbearing age with abdominal or pelvic pain, constipation of recent onset or occlusive bowel, which may or may not be related to the menstrual cycle should be considered transmural infiltration by endometrial tissue.

[Anal incontinence caused by an obstetric trauma. Experience with the technique of overlapping sphincteroplasty]. / Incontinencia anal causada por un traumatismo obstétrico. Experiencia con la técnica de esfinteroplastia por superposición.

INTRODUCTION: Anal incontinence (IA) could be of idiopathic, congenital, neurological origin, or secondary to trauma. Obstetric trauma is the most common cause of the traumatic anal incontinence. OBJECTIVE: To analyze results of a group of patients with anal incontinence secondary to obstetric trauma, with overlapping sphincteroplasty. PATIENTS AND METHODS: All patients with anal incontinence secondary to obstetric trauma without neurological damage, between January 2002 to January 2006 were studied; all of them underwent overlapping sphincteroplasty. We evaluated improvement in incontinence score according Jorge and Wexner incontinence scale, pre and postoperatively as well as morbi-mortality rates. RESULTS: 16 patients, most of them with total anal incontinence, with preoperative values between 16 to 20 points at the Jorge and Wexner scale; 14 patients (87.5%) referred improvement in their values with 4 to 0 points postoperatively, two patients did not refer significant improvement, both of them with defects in both sphincters and loss of the 50% of the entire sphincteric complex. They were sent to bio-feedback therapy. There was not mortality. Seven patients (43.7%) had skin dehiscence. CONCLUSIONS: Overlapping sphincteroplasty is an accurately technique for repair obstetric trauma injuries of the anal sphincter, with a success rate of 70 to 80%, and a low morbidity rate.