2. Unusual Case of Intestinal Endometriosis

S. Tonoda, M Katsumi, S. Ura, H. Mishima, Y Katsube, Goichi Morimoto, Masamitu Enomoto, Takanori Yamaguchi, K Matsumoto, Koji Uda
In: Nippon Daicho Komonbyo Gakkai Zasshi · 1975 · vol. 28(1) , pp. 9–15,68 · doi:10.3862/jcoloproctology.28.9 · W2324825356
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A case report describes a 33-year-old female with intestinal endometriosis presenting as a rectal mass and ileocecal stenosis, treated initially with resection and colostomy, followed by hormonal therapy and further surgery.

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This paper reports an unusual clinical case of a 33-year-old woman with lower abdominal pain and anal bleeding who was initially diagnosed intraoperatively as having rectal or left ovarian carcinoma based on imaging filling defects and small polypoid rectal lesions. Laparotomy revealed an unresectable carcinomatoid rectal mass occupying the small pelvic space and a separate ileocecal metastatic-appearing lesion causing intestinal stenosis, leading to ileocecal resection and a single barrel colostomy, after which pathology identified intestinal endometriosis. She then received gestagen therapy for six months, and after a marked reduction of the mass she underwent anterior resection of the rectum with hysterectomy and bilateral adnexectomy, with the resected specimen showing left adnexa penetrating through the rectal wall and other pathology minimal. This paper is centrally about endometriosis — specifically a case report of intestinal endometriosis presenting as a carcinomatoid rectal mass with ileocecal stenosis.

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Abstract

A 33-year-old female, complaining of lower abdominal pain and anal bleeding, underwent a laparotomy under the diagnosis of rectal or left ovarial carcinoma, because of fillings defects detected on X-ray examination and a few tiny polypoid tumors noticed by colonofiber-scopy in the rectum.At laparotomy, an unresectable carcinomatoid mass originating in the rectum was found to occupy all the small pelvic space, and a metastatic tumor at the ileocoecal region was also found to create intestinal stenosis.Therefore, an ileocoecal resection and a single barrel colostomy were performed. The postoperative pathological diagnosis was intestinal endometriosis. Hence, she had a gestagen therapy for the period of six months prior to the second surgery.After the remarkable reduction of the mass, she underwent an anterior resection of the rectum combined with a hystrectomy with bilateral adnexectomies.The specimen obtained by the second surgery demonstrated the left adnex penetrating through the rectal wall, while the other pathological changes were proved minimal.
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2. Unusual Case of Intestinal Endometriosis 1975 Volume 28 Issue 1 Pages 9-15,68 Details Abstract A 33-year-old female, complaining of lower abdominal pain and anal bleeding, underwent a laparotomy under the diagnosis of rectal or left ovarial carcinoma, because of fillings defects detected on X-ray examination and a few tiny polypoid tumors noticed by colonofiber-scopy in the rectum. At laparotomy, an unresectable carcinomatoid mass originating in the rectum was found to occupy all the small pelvic space, and a metastatic tumor at the ileocoecal region was also found to create intestinal stenosis. Therefore, an ileocoecal resection and a single barrel colostomy were performed. The postoperative pathological diagnosis was intestinal endometriosis. Hence, she had a gestagen therapy for the period of six months prior to the second surgery. After the remarkable reduction of the mass, she underwent an anterior resection of the rectum combined with a hystrectomy with bilateral adnexectomies. The specimen obtained by the second surgery demonstrated the left adnex penetrating through the rectal wall, while the other pathological changes were proved minimal. At laparotomy, an unresectable carcinomatoid mass originating in the rectum was found to occupy all the small pelvic space, and a metastatic tumor at the ileocoecal region was also found to create intestinal stenosis. Therefore, an ileocoecal resection and a single barrel colostomy were performed. The postoperative pathological diagnosis was intestinal endometriosis. Hence, she had a gestagen therapy for the period of six months prior to the second surgery. After the remarkable reduction of the mass, she underwent an anterior resection of the rectum combined with a hystrectomy with bilateral adnexectomies. The specimen obtained by the second surgery demonstrated the left adnex penetrating through the rectal wall, while the other pathological changes were proved minimal. © The Japan Society of Coloproctology この記事はクリエイティブ・コモンズ [表示 - 非営利 - 改変禁止 4.0 国際]ライセンスの下に提供されています。 https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja Favorites & Alerts Recently viewed articles Predecessor

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endometriosis

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