A 32-year-old woman with deep endometriosis underwent surgical resection of endometriotic foci. Intraoperatively, resection of a nodule involving the left pelvic wall extending to the pelvic floor musculature and the left pararectal region was performed. An inadvertent 4-cm injury to the mid-rectum occurred, compromising approximately 70% of the circumference. A decision was made to perform a rectosigmoidectomy with closure of the rectal stump and creation of an end colostomy. Two months later, during the procedure for intestinal reconstruction, a fistula was identified on the lateral rectal wall, 3.5 cm from the anal verge. The fistula was surgically closed, followed by a mechanical colorectal anastomosis and protective ileostomy. Prior to ileostomy reversal, a stenosis of the colorectal anastomosis was identified, and colonoscopy was requested to evaluate the possibility of dilation. Endoscopic examination revealed, 7 cm from the anal verge, circumferential scar retraction consistent with a complete anastomotic stenosis, with no identifiable lumen for conventional dilation. Treatment consisted of dissecting the center of the stenosis using a needle-knife, followed by guidewire passage and contrast injection under fluoroscopic guidance, delineating the pre-anastomotic intestinal loop. Hydrostatic balloon dilation was then performed up to 12 mm. Afterward, passage of the gastroscope through the stenosis was achieved. One week later, repeat colonoscopy demonstrated a patent anastomosis, allowing scope passage and dilation up to 15 mm. Eleven days after that, another dilation was performed using a balloon up to 16.5 mm, immediately before ileostomy closure. The patient had an uneventful postoperative course and resumed normal bowel function