A case of ileal endometriosis causing frequent small bowel obstructions in a short time

Haruka Yoshida, Tomohiro Kudo, Keisuke Shiina, Atsushi Naganuma
In: Progress of Digestive Endoscopy · 2015 · vol. 87(1) , pp. 164–165 · doi:10.11641/pde.87.1_164 · W2683730226
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This case report details a 38-year-old woman with recurrent small bowel obstructions diagnosed post-operatively as ileal endometriosis involving the appendix and a regional lymph node.

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A 38-year-old woman presented with recurrent small bowel obstructions due to a tumorous lesion at the terminal ileum, which was initially misdiagnosed as non-specific ileitis via biopsy. Following multiple hospitalizations and laparoscopic ileocecal resection, histopathological examination revealed endometrial glands and stroma infiltrating all layers of the intestinal wall, confirming a diagnosis of ileal endometriosis. The study also noted the presence of similar glandular structures in the appendix and a regional lymph node, indicating potential spread or associated lesions. This paper is centrally about endometriosis — specifically describing a rare case of deep infiltrating endometriosis affecting the small intestine and causing acute obstruction.

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Abstract

A 38-year-old woman presented to our hospital with abdominal pain and vomiting. Abdominal computed tomography revealed intestinal obstruction caused by a tumorous lesion at the terminal ileum. Colonoscopy showed an elevated lesion like a submucosal tumor in the terminal ileum. Although the bioptic diagnosis was non-specific ileitis, she had two recurrences within two months after the first hospitalization. Laparoscopic ileocecal resection with lymph node dissection was performed as a diagnostic modality during the third hospitalization. Macroscopic findings showed that the serous surface of the terminal ileum coalesced fibrously, and the mucosal side bulged outward into the ileal lumen. On histopathological examination, all layers of the tumorous lesion showed a structure similar to the uterine stroma and glands infiltrate. Thus, ileal endometriosis was diagnosed. The glandular structure was also present in the appendix and a regional lymph node (#202) .
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症例 短期間にイレウスを繰り返した回腸末端の腸管子宮内膜症の1例 2015 年 87 巻 1 号 p. 164-165 詳細 抄録 A 38-year-old woman presented to our hospital with abdominal pain and vomiting. Abdominal computed tomography revealed intestinal obstruction caused by a tumorous lesion at the terminal ileum. Colonoscopy showed an elevated lesion like a submucosal tumor in the terminal ileum. Although the bioptic diagnosis was non-specific ileitis, she had two recurrences within two months after the first hospitalization. Laparoscopic ileocecal resection with lymph node dissection was performed as a diagnostic modality during the third hospitalization. Macroscopic findings showed that the serous surface of the terminal ileum coalesced fibrously, and the mucosal side bulged outward into the ileal lumen. On histopathological examination, all layers of the tumorous lesion showed a structure similar to the uterine stroma and glands infiltrate. Thus, ileal endometriosis was diagnosed. The glandular structure was also present in the appendix and a regional lymph node (#202) . © 2015 一般社団法人 日本消化器内視鏡学会 関東支部

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endometriosis

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