A Case of Ileal Endometriosis with Lymph-node Involvement Presented with Small Bowel Obstruction

Hyogo SAWAZAKI, Setsuji Takanashi, Kazuki Asanuma, Naoki Morohoshi, M. Ishigooka, Hideaki KAWASHIMA
In: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) · 2014 · vol. 75(12) , pp. 3358–3363 · doi:10.3919/jjsa.75.3358 · W2713715277
article OA: bronze CC0 ⤵ 2 in-corpus citations
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Abstract

症例は，43歳の女性．入院5カ月前に前医で腹式卵巣嚢胞核出術と子宮筋腫核出術を受け，経過良好で退院した．1カ月前の受診で持続する腹痛と腸管拡張を認め腸閉塞と診断．保存的加療後，症状改善なく当院紹介受診となった．腹部CT所見で腸閉塞を疑い，開腹手術を施行した．手術所見では，明らかな絞扼部位を認めず，回腸末端に1.5cm大の弾性硬の腫瘤を触知し，その口側腸管の拡張を認めた．悪性腫瘍が否定できなかったため，回盲部切除D3郭清を施行した．病理組織所見は，回腸末端部に輪状の狭窄を認めた．粘膜に病変認めず，狭窄部割面は白色，筋層から漿膜下組織の線維化が著明で内部に子宮内膜間質を伴った子宮内膜を認めた．腸管傍リンパ節にも子宮内膜組織の像を認めた．

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endometriosis

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