A Case of Endometriosis of the Sigmoid Colon: Usefulness of MRI for Diagnosis of Intestinal Endometriosis

Koji Obara, Rikisaburo Sahara, T. Yamana, Kentaro Okamoto, T. Takahashi, K. Komura, Sachiho Furukawa, Daikichi Okada, Kazuhiko Ohhashi, Y. Kaneko, Alvin M. Matsumoto
In: Nippon Daicho Komonbyo Gakkai Zasshi · 2008 · vol. 61(1) , pp. 51–55 · doi:10.3862/jcoloproctology.61.51 · W2003712118
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This case report highlights the usefulness of MRI in diagnosing sigmoid colon endometriosis, which presented with imaging findings suggestive of hemorrhage and lacked contrast enhancement on MRI.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This paper reports a single 39-year-old woman with sigmoid colon endometriosis presenting with abdominal pain, evaluated using conventional imaging (barium enema and endoscopy) plus high-resolution ultrasound endoscopy and MRI. The authors found characteristic imaging features including transverse ridging and unilateral granular/mound-like mucosal changes, nonspecific biopsy results with inflammation, and full-thickness hyperechoic findings on 12 MHz ultrasound endoscopy; MRI showed thickened bowel wall with T1 high signal suggesting hemorrhage but no gadolinium enhancement, leading them to exclude a tumor. The case was managed with hormonal therapy, with improvement in clinical symptoms, while acknowledging limits of conservative treatment and the need for careful follow-up regarding potential malignant risk. This paper is centrally about endometriosis — specifically MRI usefulness in diagnosing intestinal (sigmoid colon) endometriosis.

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Abstract

内視鏡，注腸など従来の画像診断に加えMRIが診断に有用であったS状結腸子宮内膜症の1例を経験したので報告する．症例は39歳女性で腹痛を主訴に受診．注腸造影でtransverse ridging, 内視鏡では病変部に一致して片側性に顆粒状粘膜，小隆起に囲まれた中に発赤，びらん面を認めた．生検で炎症細胞浸潤をともなう非特異的所見のみであった．12MHz超音波内視鏡で病変部に一致した全層性の高エコー像を認めた．T1強調MRI像で病変部に相当する肥厚した大腸壁内に出血の存在を示唆する高信号を認め，ガドリニウム造影で同部位に造影効果は認められなかった．以上より腫瘍性病変は否定的と考え，S状結腸子宮内膜症と診断．ホルモン療法により腹痛などの臨床症状は軽快.保存的治療の限界，悪性化の危険性などのインフォームド·コンセントを行った上で本人の希望に沿い注意深い観察のもと経過観察を行っている．
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症例報告 S状結腸子宮内膜症の診断にMRIが有用であった1例 2008 年 61 巻 1 号 p. 51-55 詳細 抄録 内視鏡，注腸など従来の画像診断に加えMRIが診断に有用であったS状結腸子宮内膜症の1例を経験したので報告する．症例は39歳女性で腹痛を主訴に受診．注腸造影でtransverse ridging, 内視鏡では病変部に一致して片側性に顆粒状粘膜，小隆起に囲まれた中に発赤，びらん面を認めた．生検で炎症細胞浸潤をともなう非特異的所見のみであった．12MHz超音波内視鏡で病変部に一致した全層性の高エコー像を認めた．T1強調MRI像で病変部に相当する肥厚した大腸壁内に出血の存在を示唆する高信号を認め，ガドリニウム造影で同部位に造影効果は認められなかった．以上より腫瘍性病変は否定的と考え，S状結腸子宮内膜症と診断．ホルモン療法により腹痛などの臨床症状は軽快.保存的治療の限界，悪性化の危険性などのインフォームド·コンセントを行った上で本人の希望に沿い注意深い観察のもと経過観察を行っている． © 2008 日本大腸肛門病学会 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

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endometriosis

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