Two Cases of Endometriosis of the Ileum Presented with Intestinal Obstruction.

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  • 腸閉塞にて発症した回腸子宮内膜症の２例

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Abstract

We report two cases of endometriosis of the ileum presented with intestinal obstruction, together with a review of 25 domestic cases. Patient 1, a 47-year-old woman presented with abdominal pain and vomiting, was admitted to the hospital with a diagnosis of intestinal obstruction. Although she was treated with decompression of the intestine by an ileus tube, she had sudden onset with strong abdominal pain. An abdominal X-ray film revealed intra-abdominal free air 3 days after the treatment by the ileus tube. Emergency operation was performed with a diagnosis of gastrointestinal perforation. Closure of perforation and a partial resection of the intestine were performed because of intestinal stenosis at four positions and perforation of the small intestine at oral side of the stenosis. Patient 2, a 43-year-old woman, was admitted to the hospital with a diagnosis of bacteriological colitis. She had a good course by conservative therapy, but developed abdominal pain and distention in a few days after the start of oral taking. Intestinal obstruction was diagnosed. Because decompression of the intestine was unsuccessful, the patient was operated on. At laparotomy, severe intestinal stenosis was present in the end of ileum which seemed to be a malignant tumor. Ileocecal resection with lymphadenectomy was performed. Both cases were diagnosed as endometriosis of the ileum on the basis of histopathological findings.<br> Endometriosis of the small intestine often presents with intestinal obstruction, but it is difficult to make the preoperative diagnosis of the disease. Ileal endometriosis must be kept in mind as a probable underlying disease of intestinal obstruction.

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