Sonographic Pitfall in Endometriotic Ovarian Cysts: A Rare Case of a Spontaneous Sigmoid Colonic Perforation in a Nonpregnant Woman

Endometriosis involving the bowel has an estimated prevalence of 8% to 12% in women with endometriosis. We report a case of spontaneous sigmoid colonic perforation in a nonpregnant woman with endometriosis. Only a few cases of spontaneous endometriosis- related sigmoid perforation have been reported in the literature, frequently occurring during pregnancy or associated with previous surgery for deep pelvic endometriosis or in vitro fertilization treatments. Transvaginal sonography is considered an effective technique for staging pelvic endometriosis In this case, the periovarian abscess was multilocular, with low-level echogenicity and poor peripheral vascularization This case is relevant, as it shows the sonographic pattern of a spontaneous endometriosis-related sigmoid perforation mimicking an ovarian endometrioma, and it may, therefore prompt the early detection of this rare complication.