Two Cases of Endometriosis of the Ileum Presented with Intestinal Obstruction.

Kenji Mimatsu, Wakato UGAGIN, Hiroshi Koide, Yoshinori TAKEKAWA, Masahiro Fukuzawa
In: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) · 2002 · vol. 63(6) , pp. 1541–1545 · doi:10.3919/jjsa.63.1541 · W2317248028
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This paper reports two cases of ileal endometriosis presenting with intestinal obstruction, one requiring emergency surgery for perforation and the other treated with ileocecal resection.

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The paper reports two cases of ileal endometriosis presenting as intestinal obstruction in women aged 47 and 43. In case 1, a patient admitted with abdominal pain and vomiting was treated for ileus but developed gastrointestinal perforation requiring emergency surgery, where multiple strictures in the terminal ileum and a perforation were found; in case 2, a patient treated conservatively for presumed bacterial enteritis later developed pain and distension and underwent surgery for persistent obstruction, with a markedly malignant-appearing stricture at the terminal ileum; both cases were diagnosed as ileal endometriosis on postoperative pathology. The authors note that while small-bowel endometriosis commonly presents with bowel obstruction, preoperative and intraoperative diagnosis is often difficult. This paper is centrally about endometriosis — it specifically describes ileal (small-intestinal) endometriosis cases that manifested as intestinal obstruction and discusses the diagnostic challenge.

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Abstract

症例1は47歳,女性.腹痛,嘔吐を主訴に腸閉塞の診断で入院となった.イレウス管による加療施行したが,消化管穿孔を発症し緊急手術を施行した.手術所見では,回腸末端に4カ所の狭窄と口側の小腸に1カ所穿孔を認めた.穿孔部縫合閉鎖,回腸部分切除を施行した.症例2は43歳,女性.細菌性腸炎の診断で入院し,保存的加療で軽快したが,経口摂取開始後に腹痛,腹部膨満出現し腸閉塞と診断された.イレウス管による加療するも軽快せず手術施行した.手術所見では,回腸末端に悪性腫瘍を思わせる強度の狭窄を認めた.回盲部切除,リンパ節郭清術を施行した.症例1, 2ともに術後病理診断により回腸子宮内膜症と診断された. 小腸子宮内膜症は腸閉塞で発症することが多いが,その術前,術中診断は困難である場合が多い.今回,自験例2例を含めた本邦報告例26例を検討したので報告する.
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腸閉塞にて発症した回腸子宮内膜症の2例 2002 年 63 巻 6 号 p. 1541-1545 詳細 抄録 症例1は47歳,女性.腹痛,嘔吐を主訴に腸閉塞の診断で入院となった.イレウス管による加療施行したが,消化管穿孔を発症し緊急手術を施行した.手術所見では,回腸末端に4カ所の狭窄と口側の小腸に1カ所穿孔を認めた.穿孔部縫合閉鎖,回腸部分切除を施行した.症例2は43歳,女性.細菌性腸炎の診断で入院し,保存的加療で軽快したが,経口摂取開始後に腹痛,腹部膨満出現し腸閉塞と診断された.イレウス管による加療するも軽快せず手術施行した.手術所見では,回腸末端に悪性腫瘍を思わせる強度の狭窄を認めた.回盲部切除,リンパ節郭清術を施行した.症例1, 2ともに術後病理診断により回腸子宮内膜症と診断された. 小腸子宮内膜症は腸閉塞で発症することが多いが,その術前,術中診断は困難である場合が多い.今回,自験例2例を含めた本邦報告例26例を検討したので報告する. 小腸子宮内膜症は腸閉塞で発症することが多いが,その術前,術中診断は困難である場合が多い.今回,自験例2例を含めた本邦報告例26例を検討したので報告する. © 日本臨床外科学会

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