Postlaparoscopic Small Bowel Obstruction Secondary to Unrecognized Nodular Endometriosis of the Terminal Ileum

Dmowski WP, W. Paul Dmowski, W P Dmowski, N Rana, Rana N, Nasir Rana, Nercy Jafari, N Jafari, Jafari N
The Journal of the American Association of Gynecologic Laparoscopists · 2001 · vol. 8(1) , pp. 161–166 · doi:10.1016/s1074-3804(05)60569-5 · PMID:11172135 · W2101859268
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This case report describes a patient who developed a small bowel obstruction after laparoscopic surgery due to previously undetected nodular endometriosis affecting the terminal ileum.

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Abstract

Small bowel involvement by endometriosis occurs in about 0.5% of patients, but nodular endometriosis involving the entire wall of the terminal ileum is extremely rare. Endometriotic nodules protruding into the intestinal lumen may lead to chronic, partial, or acute complete small bowel obstruction and associated clinical changes. If obstruction is partial, preoperative diagnosis is difficult and seldom suspected, and no reliable diagnostic tests are available. At laparoscopic surgery, performed typically for associated pelvic endometriosis, bowel lesions may easily be overlooked, especially in women with abdominal adhesions from earlier surgery. Surgical injury, tension tears, or postoperative edema may contribute in such cases to the development of acute, complete small bowel obstruction, which may be difficult to differentiate from postoperative ileus. The patient may deteriorate rapidly and develop abdominal sepsis and multiple organ failure with high risk of mortality. Because of increased production of tumor necrosis factor-alpha by autologous monocytes, endometriosis may predispose to development of severe sepsis and septic shock. (J Am Assoc Gynecol Laparosc 8(1):161-166, 2001)

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Ileal Diseases Intestinal Obstruction Laparoscopy Ovarian Diseases Ovarian Diseases Adult Endometriosis Endometriosis Endometriosis Female Humans Ileal Diseases Ileal Diseases Ileal Diseases Intestinal Obstruction Ovarian Diseases Postoperative Complications Tumor Necrosis Factor-alpha Tumor Necrosis Factor-alpha

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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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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