A case of small intestinal endometriosis with bowel obstruction and perforation

DOI PubMed
  • KITAMURA Kazuki
    Division of Gastroenterology, Japanese Red Cross Toyama Hospital Division of Gastroenterology, Third Department of Internal Medicine, Toyama University Hospital
  • SHINAGAWA Kazuko
    Division of Gastroenterology, Japanese Red Cross Toyama Hospital
  • TOKUNAGA Mami
    Division of Gastroenterology, Japanese Red Cross Toyama Hospital
  • KOBAYASHI Saito
    Division of Gastroenterology, Japanese Red Cross Toyama Hospital
  • UEDA Akira
    Division of Gastroenterology, Japanese Red Cross Toyama Hospital Division of Gastroenterology, Third Department of Internal Medicine, Toyama University Hospital
  • TOKIMITSU Yoshiharu
    Division of Gastroenterology, Japanese Red Cross Toyama Hospital
  • OKADA Kazuhiko
    Division of Gastroenterology, Japanese Red Cross Toyama Hospital
  • MAEDA Yoshinobu
    Division of Pathology, Japanese Red Cross Toyama Hospital
  • SHIBAHARA Kazushige
    Division of Surgery, Japanese Red Cross Toyama Hospital
  • YASUDA Ichiro
    Division of Gastroenterology, Third Department of Internal Medicine, Toyama University Hospital

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Other Title
  • 腸閉塞を発症し穿孔をきたした小腸子宮内膜症の1例

Abstract

<p>A 47-year-old woman was referred to our hospital with recurring lower abdominal pain persisting for more than 2 weeks. Imaging modalities showed small bowel obstruction caused by a mass lesion in the terminal ileum. Despite undergoing fasting, rehydration, and decompression through an ileus tube, her symptoms persisted. Furthermore, the condition deteriorated on day 4, with the onset of her menstrual period. An emergency surgery was conducted on the 7th day after hospitalization. Surgical observations indicated severe stenosis around the ileocecal valve and ileal perforation approximately 40cm from the oral stricture. As a result, ileocecal resection was performed. Pathological examination revealed endometrial tissue infiltration through the mucosal lamina propria to the ileal subserosa. Thus, the patient was identified with intestinal endometriosis of the ileocecum. Endometriosis of the small bowel is an uncommon condition that eventually causes intractable bowel obstruction. Although preoperative diagnosis is considered challenging, intestinal endometriosis should be included in the differential diagnosis in cases of bowel obstruction in women of childbearing age.</p>

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