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

In: 四国医学雑誌 · 2021 · vol. 77 , pp. 149–154 · W3206327942
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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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endometriosisbowel_endometriosis

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