Crohn's disease mimicking as bowel endometriosis

Atsuhito Nakao, A Nakao, H Iwagaki, Hiromi Iwagaki, Taiichiro Kanagawa, T Kanagawa, A Jikuhara, Atsushi Jikuhara, Naoko Matsubara, N Matsubara, N Takakura, Norio TAKAKURA, H Isozaki, Hiroshi Isozaki, Noboru Tanaka, N Tanaka
Archives of gynecology and obstetrics · 2000 · vol. 263(3) , pp. 131–133 · doi:10.1007/s004040050011 · PMID:10763842 · W2027363280
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-11 ⓘ

This case report describes a 27-year-old female initially misdiagnosed with bowel endometriosis whose resection revealed Crohn's disease, and highlights potential ACTH/cortisol increases with nafarelin therapy.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text ⓘ

The paper reports a 27-year-old woman whose abdominal pain and fullness recurred monthly around menstruation and was initially misdiagnosed as intestinal endometriosis, although she was ultimately found to have Crohn’s disease. After starting nafarelin acetate therapy, her symptoms from mechanical subileus improved, but she underwent resection of the transverse colon and a 70 cm ileal segment, including the terminal ileum, due to repeated bowel obstruction despite prolonged nafarelin. Histopathology of the resected tissue showed Crohn’s disease without endometrial tissue, and the authors noted increased cortisol and ACTH secretion during nafarelin, which they considered to suppress Crohn’s inflammation. This paper is centrally about endometriosis—specifically, it presents Crohn’s disease mimicking bowel endometriosis and highlights diagnostic differentiation in that context.

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Abstract We report a 27-year-old female with Crohn’s disease clinically misdiagnosed with intestinal endometriosis. Her complaints were abdominal pain and fullness, which occurred monthly during her menstual period. Although we had no histopathological evidence, we diagnosed her as bowel endometriosis on the basis of her clinical course. Since nafarelin acetate therapy started, the symptoms due to mechanical subileus have improved. The transverse colon, a 70 cm segment of the ileum, including the terminal ileum, were resected because of repeated symptoms of bowel obstruction despite prolonged nafarelin therapy. Histopathological findings of the resected specimen revealed Crohn’s disease without endometrial tissue. In our patient, an increased cortisol and ACTH secretion, a side effect of nafarelin, was noted during the therapy. This case showed that nafarelin therapy could increase serum concentration of ACTH and cortisol, which was considered to suppress the pathology of Crohn’s disease by its anti-inflammatory action. We emphasize that intestinal examination must be performed with Crohn’s disease in mind, even if nafarelin acetate is effective. Similar content being viewed by others Author information Authors and Affiliations Additional information Received: February 1999 / Accepted: 28 May 1999 Rights and permissions About this article Cite this article Nakao, A., Iwagaki, H., Kanagawa, T. et al. Crohn’s disease mimicking as bowel endometriosis . Arch Gynecol Obstet 263, 131–133 (2000). https://doi.org/10.1007/s004040050011 Issue date: DOI: https://doi.org/10.1007/s004040050011

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Colonic Diseases Crohn Disease Endometriosis Hormones Nafarelin Adrenocorticotropic Hormone Adrenocorticotropic Hormone Adult Colon Colon Colonic Diseases Colonic Diseases Colonic Diseases Crohn Disease Crohn Disease Crohn Disease Diagnostic Errors Endometriosis Endometriosis Endometriosis

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