OBJECTIVE: Authors report their experience about a case of intestinal 
endometriosis that lead cyclic and recurrent rectal bleeding in a fertile-age 
woman.
DESIGN: Report of 1 case with multidisciplinary approach and surgical treatment. 
Surgical effectiveness evaluation and 2 years follow-up. Brief review on the 
recent literature and the diagnostic and therapeutic implications.
SETTING: Section of General and Thoracic Surgery, Department of General Surgery, 
Emergency and Organ Transplantation, Policlinico "Paolo Giaccone", Palermo.
INTERVENTION: After correct and sure diagnosis, the patient was submitted to 
sigmoid segmental resection with radical and curative intention.
RESULTS: Complete recovery. Follow-up (24 months) negative.
CONCLUSIONS: Diagnosis of endometriosis should be considered in women with 
recurrent monthly abdominal pain and bowel symptoms, especially if accompanied 
by gynaecologic complaints, even because the significant symptoms overlap with 
the irritable bowel syndrome (IBS) and makes the differentiation extremely 
difficult. Treatment of GI endometriosis is best approached in collaboration 
between gynaecologist experienced and intestinal surgeon. The high accuracy and 
low complications suggested that EUS-FNA was effective for the correct 
histologic diagnosis of intestinal endometriosis.