Martimbeau P W, Pratt J H, Gaffey T A
Mayo Clin Proc. 1975 May;50(5):239-43.
Though endometriosis is a frequent finding in females, it rarely causes obstruction of the small bowel. However, 11 patients with such obstruction were seen at the Mayo Clinic in the years 1950 through 1970. Their ages ranged from 27 years to 51. A portion of involved bowel had to be resected in every case, but most of the lesions were single. Generally the obstructions were subacute and did not produce surgical emergencies. But because the symptoms were neither specific nor acute, the diagnosis seldom was established prior to laparotomy and the majority of the resections were performed without bowel preparation. Nevertheless, morbidity was minor in most cases and there was no mortality. Small-bowel obstruction has not recurred. Endometriosis of the small bowel tends to be limited to the serosa and the muscular coats, not penetrating the mucosa; and obstruction is due to fibrosis and kinking of the bowel. The obstructed segment usually must be resected. If pelvic endometriosis is minimal, no further surgery is necessary. But if the pelvic lesions are extensive, or if multiple sites in the small and large intestines are involved, then more radical resection and bilateral oophorectomy are indicated.
虽然子宫内膜异位症在女性中很常见，但很少导致小肠梗阻。然而，1950年至1970年间，梅奥诊所共收治了11例此类梗阻患者。她们的年龄在27岁至51岁之间。每例患者均需切除部分受累肠段，但大多数病变为单发。一般来说，梗阻为亚急性，不会引发外科急症。但由于症状既不特异也不急性，诊断很少能在剖腹手术前确立，大多数切除术在未进行肠道准备的情况下进行。尽管如此，大多数病例的发病率较低，且无死亡病例。小肠梗阻未复发。小肠子宫内膜异位症往往局限于浆膜层和肌层，不穿透黏膜；梗阻是由肠管纤维化和扭结引起的。通常必须切除梗阻段。如果盆腔子宫内膜异位症较轻，则无需进一步手术。但如果盆腔病变广泛，或小肠和大肠多处受累，则需进行更彻底的切除及双侧卵巢切除术。
