López Pedro A, Martín Luis, Vicente Manuel, Girón Oscar, del Pozo Manuel
Servicio de Cirugía General y Aparato Digestivo II, Hospital Universitario Virgen de la Arrixaca, El Palmar, B.30007 Murcia, Spain.
Cir Esp. 2007 Aug;82(2):122-4. doi: 10.1016/s0009-739x(07)71679-2.
Endometriosis is an endometrial tissue proliferation that occurs in any extrauterine site and is usually confined to the pelvis. When the terminal ileum is affected, this entity can simulate Crohn's disease both clinically and radiologically. We describe 2 patients previously diagnosed with Crohn's disease with inadequate response to treatment, who showed intestinal obstruction located in the ileum. One patient had an enterocutaneous fistula, which is extremely unusual. In both patients intestinal endometriosis was diagnosed after histopathologic assessment. Although complex, the differential diagnosis between endometriosis and Crohn's disease should be kept in mind since the prognosis and treatment of these 2 entities differ.
子宫内膜异位症是指子宫内膜组织在子宫外任何部位的增殖,通常局限于盆腔。当回肠末端受累时,该病症在临床和影像学上可类似克罗恩病。我们描述了2例先前诊断为克罗恩病但治疗反应不佳的患者,他们表现为回肠梗阻。其中1例患者有肠皮肤瘘,这极为罕见。两名患者经组织病理学评估后均被诊断为肠道子宫内膜异位症。尽管鉴别诊断较为复杂,但鉴于这两种病症的预后和治疗方法不同,仍应牢记子宫内膜异位症与克罗恩病之间的鉴别诊断。