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This paper reports a rare case of ileal endometriosis causing intestinal obstruction in a 38-year-old woman, and reviews 13 similar Japanese cases. Using decompression and preoperative imaging (enterography, abdominal CT, abdominal ultrasonography, and enema), the authors identified ileal occlusion and bilateral ovarian cystomas, and laparotomy showed pelvic adhesions, ovarian cystomas, and tumorous lesions at the terminal ileum and cecum; frozen section confirmed endometriosis of the ileum. The paper emphasizes that decompression allowed elective surgery and that intraoperative frozen section was important for appropriate operative management. This paper is centrally about endometriosis — specifically ileal (intrinsic) endometriosis causing intestinal obstruction, with additional cecal involvement.
Abstract
We report on a case of very rare endometriosis of the ileum causing intestinal obstruction and present a review of 13 cases of the disease reported in Japan.A 38-year-old woman visited the hospital because of intestinal obstruction. After conducting decompression of the intestinal tract with a long tube, enterography, abdominal CT, abdominal ultrasonography, and enema were performed, all clearly showing occlusion of the ileum and bilateral ovarian cystomas.Laparotomy findings revealed marked adhesions in the pelvic cavity, bilateral ovarian cystomas, and tumorous lesions at the terminal portion of the ileum and at the cecum. Frozen section diagnosis showed the tumor in the ileum to be endometriosis. From the above, the diagnosis of intrinsic endometriosis and endometriosis of the ileum and cecum causing intestinal obstruction was made. Bilateral adnexectomy, simple total hysterectomy, and ileocecal excision were performed.Decompression therapy against intestinal obstruction enabled elective surgery on the basis of a more detailed preoperative diagnosis, and intraoperative frozen section diagnosis of the lesions was considered important for performing proper operation. Endometriosis of the small intestine, although a rare disease, must be kept in mind as the underlying disease of intestinal obstruction.
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A CASE OF ENDOMETRIOSIS OF THE ILEUM CAUSING INTESTINAL OBSTRUCTION
1991 Volume 52 Issue 6 Pages 1292-1297
Details
Abstract
We report on a case of very rare endometriosis of the ileum causing intestinal obstruction and present a review of 13 cases of the disease reported in Japan.
A 38-year-old woman visited the hospital because of intestinal obstruction. After conducting decompression of the intestinal tract with a long tube, enterography, abdominal CT, abdominal ultrasonography, and enema were performed, all clearly showing occlusion of the ileum and bilateral ovarian cystomas.
Laparotomy findings revealed marked adhesions in the pelvic cavity, bilateral ovarian cystomas, and tumorous lesions at the terminal portion of the ileum and at the cecum. Frozen section diagnosis showed the tumor in the ileum to be endometriosis. From the above, the diagnosis of intrinsic endometriosis and endometriosis of the ileum and cecum causing intestinal obstruction was made. Bilateral adnexectomy, simple total hysterectomy, and ileocecal excision were performed.
Decompression therapy against intestinal obstruction enabled elective surgery on the basis of a more detailed preoperative diagnosis, and intraoperative frozen section diagnosis of the lesions was considered important for performing proper operation. Endometriosis of the small intestine, although a rare disease, must be kept in mind as the underlying disease of intestinal obstruction.
A 38-year-old woman visited the hospital because of intestinal obstruction. After conducting decompression of the intestinal tract with a long tube, enterography, abdominal CT, abdominal ultrasonography, and enema were performed, all clearly showing occlusion of the ileum and bilateral ovarian cystomas.
Laparotomy findings revealed marked adhesions in the pelvic cavity, bilateral ovarian cystomas, and tumorous lesions at the terminal portion of the ileum and at the cecum. Frozen section diagnosis showed the tumor in the ileum to be endometriosis. From the above, the diagnosis of intrinsic endometriosis and endometriosis of the ileum and cecum causing intestinal obstruction was made. Bilateral adnexectomy, simple total hysterectomy, and ileocecal excision were performed.
Decompression therapy against intestinal obstruction enabled elective surgery on the basis of a more detailed preoperative diagnosis, and intraoperative frozen section diagnosis of the lesions was considered important for performing proper operation. Endometriosis of the small intestine, although a rare disease, must be kept in mind as the underlying disease of intestinal obstruction.
© Japan Surgical Association
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