A Case of Intussusception by Endometriosis of the Ileum

Keishi Aishin, Yoshihiro Sakashita, Yoshio Ogura, Naru Kondou, Norihumi Shigemoto, Yuka Ueda
In: The Japanese Journal of Gastroenterological Surgery · 2009 · vol. 42(1) , pp. 78–83 · doi:10.5833/jjgs.42.78 · W2320601325
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

A 40-year-old female presented with symptoms of intussusception, which was diagnosed via ultrasound and CT to be caused by ileal endometriosis, leading to an emergency resection.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

The paper reports a single 40-year-old woman with ileal endometriosis presenting initially with epigastric pain that improved after intravenous therapy, followed by worsening abdominal pain, nausea, and vomiting. Using abdominal ultrasound and emergency contrast CT, the authors diagnosed strangulated ileal intussusception at the ileocecal region, and performed emergency surgery where bloody ascites was found and a submucosal lesion in the terminal ileum acted as the lead point for the intussusception. After manual reduction, they resected the ileocecal area with D2 because malignancy was considered, and pathology confirmed a 3 cm submucosal endometriotic lesion. This paper is centrally about endometriosis — it is a surgical case of ileal endometriosis causing intussusception of the ileocecal region.

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Abstract

回腸子宮内膜症により回盲部腸重積を形成した1手術例を経験した．症例は40歳の女性で，心窩部痛を主訴に，2004年10月当院救急外来を受診するも，点滴治療にて症状軽快し帰宅．翌朝より嘔気，嘔吐を認め，腹痛増強し，当院救急外来を再度受診した．右下腹部に圧痛を認め，Blumberg徴候陽性．腹部エコーにて右下腹部の腸蠕動の低下および腸管の拡張，回盲部にmultiple concentric signを認めた．さらに，緊急造影CTにて腹水貯留，回腸の腫脹を認め，腸重積による絞扼性イレウスと診断し，緊急手術を施行．腹腔内には血性腹水を認めた．回腸末端に粘膜下腫瘍を認め，これがBauhin弁に重積していた．腸重積を用手的に圧出，整復後，悪性腫瘍の可能性も考慮し，回盲部切除術＋D2を施行した．切除標本では3 cm大の粘膜下腫瘍で，術後病理組織学的検査にて腸管子宮内膜症と診断された．
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抄録 回腸子宮内膜症により回盲部腸重積を形成した1手術例を経験した．症例は40歳の女性で，心窩部痛を主訴に，2004年10月当院救急外来を受診するも，点滴治療にて症状軽快し帰宅．翌朝より嘔気，嘔吐を認め，腹痛増強し，当院救急外来を再度受診した．右下腹部に圧痛を認め，Blumberg徴候陽性．腹部エコーにて右下腹部の腸蠕動の低下および腸管の拡張，回盲部にmultiple concentric signを認めた．さらに，緊急造影CTにて腹水貯留，回腸の腫脹を認め，腸重積による絞扼性イレウスと診断し，緊急手術を施行．腹腔内には血性腹水を認めた．回腸末端に粘膜下腫瘍を認め，これがBauhin弁に重積していた．腸重積を用手的に圧出，整復後，悪性腫瘍の可能性も考慮し，回盲部切除術＋D2を施行した．切除標本では3 cm大の粘膜下腫瘍で，術後病理組織学的検査にて腸管子宮内膜症と診断された． この記事はクリエイティブ・コモンズ [表示 - 非営利 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/4.0/deed.ja

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endometriosis

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