Terminal ileitis with sealed perforation?a rare complication of intestinal endometriosis: case report and short review of the literature

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This case report details a 38-year-old patient with endometriosis who presented with acute terminal ileitis and omentum-sealed perforation requiring surgical intervention.

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AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text

This paper reports a case of acute abdomen in a 38-year-old patient with previously known rectovaginal and ileocecal endometriosis, managed via emergency laparotomy after imaging suggested small-bowel ileus and laboratory tests showed marked inflammation. Intraoperatively, the authors found acute terminal ileitis with an omentum-sealed perforation, along with stenosis of the anterior rectal wall due to endometriosis, and performed partial ileal resection with anastomosis plus appendectomy and short segmental rectal resection; histology confirmed transmural endometriosis with fistulas, perforation, and deep ulceration. The report is limited by its nature as a single case with only a brief literature review, without broader diagnostic or outcome analysis. This paper is centrally about endometriosis — specifically a rare intestinal complication (terminal ileitis with sealed perforation) attributable to intestinal endometriosis.

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Abstract

Introduction Perforation is a rare complication of intestinal endometriosis. We report on a 38-year-old patient with previously known rectovaginal and ileocecal endometriosis who was referred with an acute abdomen. Case report On abdominal plain film an ileus of small intestine was diagnosed. The patient had fever, and the C-reactive protein was markedly increased. Upon emergency laparotomy an acute terminal ileitis with omentum-sealed perforation and a stenosis of the anterior wall of the rectum due to endometriosis were found. Partial resection of the ileum with end-to-end anastomosis, appendectomy, and short segmental rectum resection were performed. The postoperative course was uneventful. Histological examination corroborated the intraoperative diagnosis of fistulas, perforation and deep ulceration of the intestine consistent with transmural endometriosis.

Discussion

For proper care of these patients excellent cooperation between gynecologists and general surgeons is desirable. A short review of the literature concerning intestinal endometriosis is given. Similar content being viewed by others

References

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Arch Gynecol Obstet 269, 294–298 (2004). https://doi.org/10.1007/s00404-003-0478-9 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-003-0478-9

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Ileal Diseases Intestinal Perforation Adult Diagnosis, Differential Endometriosis Female Humans Ileal Diseases Ileal Diseases Ileal Diseases Ileal Diseases Ileal Diseases Intestinal Perforation Intestinal Perforation Intestinal Perforation Intestinal Perforation Intestinal Perforation Radiography

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