腸管子宮内膜症により直腸閉塞・敗血症性ショックをきたし，経肛門的イレウス管での減圧後待期的手術を行った一例

Tetsuyu Miyake-Hamada, Takeshi Omura, Shogo Ohta, Noriko Yokota, ryo yamada, Hiroyuki Sumitomo, Kenta Matsushita, Hayato Mori, Yoichiro Kawashita, Koji Sugimoto, Mitsuhiro Tsuboi, Tomohiko Miyatani, Yusuke Arakawa, Toshiyuki Hirose, Toshiyuki Yagi, Akiko Yoneda, Eiji Kudo
In: Shikoku Acta Medica · 2021 · vol. 77(3-4) , pp. 149–154 · W7145164878
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⚙ AI-generated summary by claude@2026-07, 2026-07-09 ⓘ

A 47-year-old woman with bowel endometriosis experienced septic shock and fecal ileus, treated initially with transanal decompression followed by laparoscopic surgery.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-09 · read from full text ⓘ

This paper reports a case of a young woman with a history of intestinal endometriosis who developed rectal bowel obstruction complicated by septic shock, and who was treated initially with decompression using a transanal drainage tube. After the patient’s general condition improved and decompression was achieved, laparoscopic surgery was performed on an elective basis, followed by discharge without postoperative complications. The authors note key limitations typical of case reports, including lack of generalizability and reliance on a single clinical trajectory, and they frame the approach as potentially stabilizing in septic-shock situations due to reduced severe intestinal distension. This paper is centrally about endometriosis — specifically bowel (rectal) endometriosis causing intestinal obstruction and septic shock managed with transanal decompression followed by elective laparoscopic surgery.

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Abstract

One of the causative diseases of intestinal obstruction in young women is bowel endometriosis. During the course of ectopic endometriosis, it is estimated that about １０％ of patients develop bowel endometriosis. The first step in treatment is drug therapy. In cases of bowel endometriosis of the colon or rectum leading to intestinal obstruction, laparotomy is often required. A ４７-year-old woman with a history of endometriosis was undergoing drug therapy. She developed abdominal pain and nausea, and was diagnosed with septic shock and fecal ileus. A transanal drainage tube was inserted for decompression. The patient’s general condition improved, and a laparoscopic low anterior resection was performed on the ２３rd day. The patient was discharged on the １０th postoperative day without any postoperative problems. This case suggests that even in the case of septic shock caused by rectal stricture due to intestinal endometriosis, initial treatment with transanal decompression may stabilize the general condition, and may be superior in cosmetic change.
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