{"paper_id":"ffafa366-b593-425d-92be-eb13d5be9e9f","body_text":"Abstract\nIntroduction\nPerforation is a rare complication of intestinal endometriosis. We report on a 38-year-old patient with previously known rectovaginal and ileocecal endometriosis who was referred with an acute abdomen.\nCase report\nOn abdominal plain film an ileus of small intestine was diagnosed. The patient had fever, and the C-reactive protein was markedly increased. Upon emergency laparotomy an acute terminal ileitis with omentum-sealed perforation and a stenosis of the anterior wall of the rectum due to endometriosis were found. Partial resection of the ileum with end-to-end anastomosis, appendectomy, and short segmental rectum resection were performed. The postoperative course was uneventful. Histological examination corroborated the intraoperative diagnosis of fistulas, perforation and deep ulceration of the intestine consistent with transmural endometriosis.\nDiscussion\nFor proper care of these patients excellent cooperation between gynecologists and general surgeons is desirable. A short review of the literature concerning intestinal endometriosis is given.\nSimilar content being viewed by others\nReferences\nAbbo L, Segre D, Liberatore E, Emmolo I, Rosso C, Landra M, Occelli M, Quaranta L (1995) [Perforated endometriosis of the sigmoid. Report of a case] (in Italian). Minerva Chir 50:393–397\nAllimant P, Bietiger M, Alhawary I Mangold J, Zeyer B (1994) [Perforation of the small intestine caused by endometriosis] (in French). J Chir (Paris) 131:313–315\nBailey HR, Ott MT, Hartendorp P (1994) Aggressive surgical management for advanced colorectal endometriosis. Dis Colon Rectum 37:747–753\nBakri YN, Tayeb A, Amri A (1992) Fatal perforation of endometriotic colon. Int J Gynaecol Obstet 37:301–302\nBossotti M, Bona A, Oliveri MG, Coda R, Micca FB, Fasciano F, Bili G (2000) Ileal perforation due to ileocecal endometriosis: a case with an unusual clinical and pathological presentation. Chir Ital 52:597–601\nCameron IC, Rogers S, Collins MC, Reed MW (1995) Intestinal endometriosis: presentation, investigation, and surgical management. Int J Colorectal Dis 10:83–86\nClement PB (1977) Perforation of the sigmoid colon during pregnancy: a rare complication of endometriosis. Case report. Br J Obstet Gynaecol 84:548–550\nCraninx M, D'Haens G, Cokelaere K, Baert F, Penninckx F, D'Hoore A, Ectors N, Rutgeerts P, Geboes K (2000) Crohn's disease and intestinal endometriosis: an intriguing co-existence. Eur J Gastroenterol Hepatol 12:217–221\nDuari M (1968) Ileal endometriosis as a surgical emergency. J R Coll Surg Edinb 13:276–282\nFloberg J, Backdahl M, Silfersward C, Thomassen PA (1984) Postpartum perforation of the colon due to endometriosis. Acta Obstet Gynecol Scand 63:183–184\nGini PC, Chukudebelu WO, Onuigbo WI (1981) Perforation of the appendix during pregnancy: a rare complication of endometriosis. Case report. Br J Obstet Gynaecol 88:456–458\nGomez-Rubio M, Fernandez R, de Cuenca B, Serantes A, Martin A, Gutierrez M L (1997) Intestinal endometriosis as a cause of chronic abdominal pain leading to intestinal obstruction. Am J Gastroenterol 92:525–526\nGoodman P, Raval B, Zimmerman G (1990) Perforation of the colon due to endometriosis. Gastrointest Radiol 15:346–348\nGraham B, Mazier WP (1988) Diagnosis and management of endometriosis of the colon and rectum. Dis Colon Rectum 31:952–956\nHopkisson J (2000) Acute small bowel obstruction due to ileal endometriosis: a case report and literature review. J R Coll Surg Edinb 45:67\nKeckstein J (1999) Die chirurgische Therapie der Endometriose. Wien Klin Wschr 13:366–371\nKinkel K, Chapron Q Balleyguier C, Fritel X, Dubuisson JB, Moreau JF (1999) Magnetic resonance imaging characteristics of deep endometriosis. Hum Reprod 14:1080–1086\nKörber J, Grammel S, Lobeck H, Weidemann H (1997) Stenose des terminalen Ileums. Endometriose als Differentialdiagnose des Morbus Crohn. Dtsch Med Wschr 122:926–929\nLedley GS, Shenk IM, Heit HA (1988) Sigmoid colon perforation due to endometriosis not associated with pregnancy. Am J Gastroenterol 83:1424–1426\nMacAffee CHG, Greer HLH (1960) Intestinal endometriosis: a report of 29 cases and a survey of the literature. J Obstet Gynaecol Br Empire 67:539–555\nMeyer R (1919) Über den Stand der Frage der Adenomyositis/Adenomyome im allgemeinen und insbesondere über Adenomyositis seroepithelialis und Endomyometritis sarcomatosa. Zentralbl Gynäkol 431:745–750\nNakatani Y, Hara M, Misugi K, Korehisa H (1987) Appendiceal endometriosis in pregnancy. Report of a case with perforation and review of the literature. Acta Pathol Jpn 37:1685–1690\nNezhat CR, Berger GS, Nezhat FR, Buttram VC Jr, Nezhat CH (eds) (1995) Endometriosis. Advanced management and surgical techniques. Springer, New York Berlin Heidelberg\nPossover M, Diebolder H, Plaul K, Schneider A (2000) Laparoscopically assisted vaginal resection of rectovaginal endometriosis. Obstet Gynecol 96:304–307\nRud B (1979) [Colonic endometriosis with perforation during pregnancy] (in Danish). Ugeskr Laeger 141:2831–2832\nSampson JA (1921) Perforating hemorrhagic (chocolate) cysts of the ovary, their importance and especially their relation to pelvic adenomas of the endometrial type. Arch Surg 3:245–247\nScarmato VJ, Levine MS, Herlinger H, Wickstrom M, Furth E, Tureck RW (2000) Ileal endometriosis: radiographic findings in five cases. Radiology 214:509–512\nShaw RW (1993) Atlas of endometriosis. Parthenon, Carnforth, pp 15–16\nStromberg C, Grane P, Hedenborg L, Leijonmarck CE (1988) [Endometriosis causing sigmoid perforation] (in Swedish). Lakartidningen 85:1333–1334\nTaylor RN, Lebovic DI, Mueller MD (2002) Angiogenic factors in endometriosis. Ann NY Acad Sci 955:89–100\nTiemann A, Bosse A, Finke U, Zumtobel V (1992) Small intestine endometriosis with lymph node involvement as a rare cause of acute abdomen. Chirurg 63:219–221\nUlrich U, Sillem M, Keckstein J (2002) Endometriose—medikamentöse und chirurgische Therapie. Med Welt 53:23–28\nWeed JC, Ray JE (1987) Endometriosis of the bowel. Obstet Gynecol 69:727–730\nWitz CA (1999) Current concepts in the pathogenesis of endometriosis. Clin Obstet Gynecol 42:566–585\nYantiss RK, Clement PB, Young RH (2001) Endometriosis of the intestinal tract: a study of 44 cases of a disease that may cause diverse challenges in clinical and pathologic evaluation. Am J Surg Pathol 25:445–454\nYelon JA, Green JM, Hashmi HF (1993) Endometriosis of the appendix resulting in perforation: a case report. J Clin Gastroenterol 16:355–356\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nDecker, D., König, J., Wardelmann, E. et al. Terminal ileitis with sealed perforation—a rare complication of intestinal endometriosis: case report and short review of the literature. Arch Gynecol Obstet 269, 294–298 (2004). https://doi.org/10.1007/s00404-003-0478-9\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-003-0478-9","source_license":"CC0","license_restricted":false}