A CASE OF OBSTRUCTIVE ILEUS CAUSED BY ENDOMETORIOSIS IN THE ILEUM

Takanori Matsui, Masato Kataoka, Y Sugita, Akio Ashida, Masanori Sekiya, Kakusyou CHEN, Takahiro Itoh, Natsuo SUZUKI, T Ichihara, Masumasa Horisawa, Akihiko Koide
In: The journal of the Japanese Practical Surgeon Society · 1995 · vol. 56(8) , pp. 1692–1695 · doi:10.3919/ringe1963.56.1692 · W2333922741
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A 45-year-old woman with endometriosis in the ileum presented with obstructive ileus during menstruation, highlighting that bowel endometriosis is rare and often difficult to diagnose preoperatively.

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This case report describes a 45-year-old woman presenting with right lower quadrant abdominal pain and intestinal obstruction, which was initially misdiagnosed as adhesive ileus following an appendectomy. Surgical intervention via ileocecal resection revealed pathological evidence of endometriosis located in the terminal ileum, confirming bowel involvement. The authors note that while bowel endometriosis causing obstruction is rare, it often presents with cyclical symptoms such as pain and constipation during menstruation, complicating pre- and intra-operative diagnosis. This paper is centrally about endometriosis — specifically deep infiltrating endometriosis affecting the small intestine and causing mechanical obstruction.

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Abstract

A 45-year-old woman seen at the department because of a right lower quadrant abdominal pain at menstruation which started about 3 years before. Abdominal X-ray film revealed intestinal obstruction. Obstructive ileus following appendectomy was suspected and the patient was operated on. During surgery, adhesive ileus at the terminal ileum was detected. Ileocecal resection was performed. Pathological diagnosis was made with endometriosis in the ileum, Bowel endometriosis causing intestinal obstruction is rare. It presents difficulty in pre-and intra-operative diagnosis. In a review of the literature, 28 cases including this case have been reported in Japan. It was characteristic of this disease that seven cases (25%) had a previous history of endometriosis, and 14 cases (50%) developed symptoms at menstruations. Those symptoms included abdominal pain, consti-pation, melena, diarrhea, and vomitting. In this case, the patient also complained of abdominal pain and constipation at menstruations. Entertaining of these characteristics, careful attitude for history taking is very important to get the correct diagnosis.
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A CASE OF OBSTRUCTIVE ILEUS CAUSED BY ENDOMETORIOSIS IN THE ILEUM 1995 Volume 56 Issue 8 Pages 1692-1695 Details Abstract A 45-year-old woman seen at the department because of a right lower quadrant abdominal pain at menstruation which started about 3 years before. Abdominal X-ray film revealed intestinal obstruction. Obstructive ileus following appendectomy was suspected and the patient was operated on. During surgery, adhesive ileus at the terminal ileum was detected. Ileocecal resection was performed. Pathological diagnosis was made with endometriosis in the ileum, Bowel endometriosis causing intestinal obstruction is rare. It presents difficulty in pre-and intra-operative diagnosis. In a review of the literature, 28 cases including this case have been reported in Japan. It was characteristic of this disease that seven cases (25%) had a previous history of endometriosis, and 14 cases (50%) developed symptoms at menstruations. Those symptoms included abdominal pain, consti-pation, melena, diarrhea, and vomitting. In this case, the patient also complained of abdominal pain and constipation at menstruations. Entertaining of these characteristics, careful attitude for history taking is very important to get the correct diagnosis. Bowel endometriosis causing intestinal obstruction is rare. It presents difficulty in pre-and intra-operative diagnosis. In a review of the literature, 28 cases including this case have been reported in Japan. It was characteristic of this disease that seven cases (25%) had a previous history of endometriosis, and 14 cases (50%) developed symptoms at menstruations. Those symptoms included abdominal pain, consti-pation, melena, diarrhea, and vomitting. In this case, the patient also complained of abdominal pain and constipation at menstruations. Entertaining of these characteristics, careful attitude for history taking is very important to get the correct diagnosis. © Japan Surgical Association Favorites & Alerts Recently viewed articles

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