Sriganeshan Vathany, Willis Irvin H, Zarate Luis A, Howard Lydia, Robinson Morton J
Arkadi M. Rywlin Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, Florida 33140, USA.
Obstet Gynecol. 2006 Feb;107(2 Pt 2):451-3. doi: 10.1097/01.AOG.0000168443.22820.2e.
Intestinal endometriosis may be complicated by bowel obstruction, colonic rupture, sepsis, and rarely, malignant transformation. Fistula formation is extremely rare.
A 26-year-old woman presented at 16 weeks of gestation with an acute abdomen suggestive of ruptured appendicitis. Blood cultures were positive for Bacteroides fragilis. At laparotomy, she was found to have a colouterine fistula with pelvic sepsis. The resected specimens demonstrated extensive uterine adenomyosis and endometriosis of the cecum, with a fistulous tract lined by endometriosis and suppurative inflammation extending from the cecum to the uterine endometrial cavity associated with severe chorioamnionitis and endomyometritis.
This case illustrates a rare complication of colouterine fistula secondary to intestinal endometriosis.
肠道子宫内膜异位症可能并发肠梗阻、结肠破裂、败血症，恶变则较为罕见。瘘管形成极为罕见。
一名26岁女性在妊娠16周时因急腹症就诊，提示阑尾炎破裂。血培养结果显示脆弱拟杆菌阳性。剖腹探查时，发现她患有结肠子宫瘘并伴有盆腔感染。切除标本显示广泛的子宫腺肌病和盲肠子宫内膜异位症，有一条由子宫内膜异位症衬里的瘘管，化脓性炎症从盲肠延伸至子宫子宫内膜腔，伴有严重的绒毛膜羊膜炎和子宫肌层炎。
本病例说明了肠道子宫内膜异位症继发结肠子宫瘘这一罕见并发症。
