腸閉塞にて発症した小腸子宮内膜症の1例  [in Japanese] A CASE OF ILEAL ENDOMETRIOSIS PRESENTED WITH INTESTINAL OBSTRUCTION  [in Japanese]

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Abstract

腸閉塞にて発症した小腸子宮内膜症の1例を経験したので報告する.症例は44歳,女性. 1年前より月経時に増強する腹痛を訴えていたが,月経困難症として経過観察されていた.今回腸閉塞症状を呈したため入院となった.保存的治療では寛解が得られず,開腹術が施行された.回盲部より20cm口側の回腸が限局性に屈曲,癒着し,腸管壁は肥厚し,口側腸管は著明に拡張していた.瘢痕性狭窄による腸閉塞と診断され,回腸分節切除が施行された.病理組織学的に粘膜下層,筋層に子宮内膜の発達がみられ,子宮内膜症と診断された.子宮内膜症が小腸に発生し,腸閉塞にて発症することは稀であり術前診断が困難であるが,成人女性が月経に伴った消化器症状を呈する場合は本症を念頭に置く必要がある.本症の特徴として症状の再発,多発病変の可能性があることを認識した術後の経過観察が必要である.

A case of ileal endometriosis presented with intestinal obstruction is reported.<br> A 44-year-old woman, complaining of abdominal pains around menstrations, had been observed as bysmenorrhea for about one year because no abnormalities were revealed on gynecological examinations. The patient became to complain of severe abdominal pains and vomiting since a month ago and was admitted to this hospital under the diagnosis of intestinal obstruction.<br> A laparotomy was performed, for conservative therapies were unsuccessful. Flextions, adhesions and intestinal wall thickness of the ileum at the 20cm oral portion from the terminal ileum were observed and the oral side intestine from this portion was markedly dilated. A segmental resection of the ileum was performed and the lesion was diagnosed as ileal endometriosis on pathological examinations.<br> It is very difficult to diagnose endometriosis of the small intestine preoperatively, because this disease rarely involves the small intestine and presents with intestinal obstruction. We have to keep this disease in mind on adult woman who manifest gastrointestinal symptoms associated with dysmenorrhea. A careful observation is reguised after operation, because it can frequently recur and often has multiple lesions.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 61(10), 2680-2684, 2000-10-25

    Japan Surgical Association

References:  11

Cited by:  4

Codes

  • NII Article ID (NAID)
    10008504317
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13452843
  • Data Source
    CJP  CJPref  J-STAGE 
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