内視鏡的直視下生検により確診し得た閉塞性大腸炎を伴う直腸子宮内膜症の1例

折居 裕, 真口 宏介, 中沢 郁生, 有里 智志, 都丸 久, 峯本 博正, 小西 行夫, 斉藤 裕輔, 浦 等, 岡村 毅與志, 並木 正義

doi:10.11280/gee1973b.31.165

It has been known that it is difficult to make a diagnosis of intestinal endometriosis by endoscopic biopsy because the mucosal surface is intact in most cases with this disorder. Recently, a case of this disorder was experienced in which endometrial gland was histopathologically confirmed in the biopsied specimen obtained from rough reddish mucosa in the rectum. Moreover, intestinal endometriosis associated with an obstructive colitis has not been reported in Japan. Therefore, the case reported here is worth recording. A-35 year old woman was admitted to our hospital because of abdominal pain, rectal bleeding and complaining of constipation for 2 weeks. Barium enema revealed stenosis in the rectum, narrowing and thumb printing sign in the descending colon. Endoscopic findings showed an elevated lesion with smooth surface in the rectum, multiple ulcers and haemorrahgic erosions in the descending colon. Mucosa of the elevated lesion in the rectum became rough and reddish coincide with her menstral period. Endometrial gland was histopathologically in the biopsied specimen obtained from this lesion. Consequently, diagnosis of endomrtriosis in the rectum associated with an obstructive colitis was made. Soon after Danazol administration all symptoms as rectal bleeding and so on disappeared. She has been free from these symptoms after the discharge from the hospital.

内視鏡的直視下生検により確診し得た閉塞性大腸炎を伴う直腸子宮内膜症の1例

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内視鏡的直視下生検により確診し得た閉塞性大腸炎を伴う直腸子宮内膜症の1例

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