Ileal endometriosis presenting as acute small intestinal obstruction: a case report

Alatise OI, O I Alatise, Sabageh D, D Sabageh, Donatus Sabageh, S O Ogunniyi, Ogunniyi SO, O O Olaofe, Olaofe OO, Olaejirinde Olaniyi Olaofe
West African journal of medicine · 2011 · vol. 29(5) , pp. 352–5 · PMID:21089025 · W22471604
Case report OA: closed CC0 ⤵ 5 in-corpus citations
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This case report details a 34-year-old woman with ileal endometriosis causing acute small intestinal obstruction, emphasizing the need for histopathology in diagnosis and consideration in women of childbearing age.

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Abstract

BACKGROUND: the gastrointestinal tract is the most common site of extrapelvic endometriosis, affecting 5%-15% of women with pelvic endometriosis. Among women with intestinal endometriosis, rectum and sigmoid colon are the most commonly involved areas. Terminal ileum is rarely involved in endometriosis. Similarly, bowel endometriosis is an uncommon cause of intestinal obstruction. OBJECTIVE: to present a rare occurrence of ileal endometriosis presenting with acute small intestinal obstruction. METHODS: a 34-year-old woman presented with a two-month history of intermittent, colicky abdominal pain which became more intense with associated vomiting of three days prior to presentation. Besides full clinical evaluation, she had other investigations including abdominal X-rays, ultrasonography, ECG, and echocardiography. The results of these informed the need for myomectomy. RESULTS: besides the abdominal pain, the patient also complained of a supra-pubic swelling and menorrhagia. Physical examination showed an incisional hernia, and a suprapubic mass. The results of evaluation were consistent with incisional hernia complicated by imminent adhesive intestinal obstruction. She had had secondary infertility and has had myomectomy due to copious menstrual flow which was complicated with incisional hernia. She was managed initially conservatively for adhesive small bowel obstruction which failed. She had exploratory laparotomy with small intestinal resection and end to end anastomosis. Histopathology of the resected mass revealed ileal endometriosis. CONCLUSION: this report highlights the importance of histopathological assessment of resected specimens in the diagnosis of intestinal obstruction due to intestinal endometriosis. This disease should, therefore, be considered during the evaluation of women of child bearing age.

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Condition tags

endometriosisbowel_endometriosisinfertility

MeSH descriptors

Endometriosis Ileal Diseases Intestinal Obstruction Abdominal Pain Abdominal Pain Abdominal Pain Adult Adult Diagnosis, Differential Diagnosis, Differential Endometriosis Endometriosis Endometriosis Endometriosis Female Female Humans Humans Ileal Diseases Ileal Diseases

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (25)

Cited by (5)

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