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腹腔镜辅助乙状结肠切除术治疗乙状结肠子宫内膜异位症:术前诊断的意义

Sigmoid colon endometriosis treated with laparoscopy-assisted sigmoidectomy: significance of preoperative diagnosis.

作者信息

Yoshida Motohira, Watanabe Yuji, Horiuchi Atsushi, Yamamoto Yuji, Sugishita Hiroki, Kawachi Kanji

机构信息

Department of Organ Regenerative Surgery, Ehime University, Shitsukawa, Toon, Ehime 791-0295, Japan.

出版信息

World J Gastroenterol. 2007 Oct 28;13(40):5400-2. doi: 10.3748/wjg.v13.i40.5400.

Abstract

We present a female patient with sigmoid colon endome-triosis who was diagnosed correctly preoperatively and underwent minimally invasive surgery. She was admitted to our hospital with rectal bleeding and constipation. We performed several workups. Colonoscopy and endoscopic ultrasonography showed sigmoid colon stenosis caused by submucosal tumor, and magnetic resonance imaging revealed a sigmoid colon tumor displaying signal hy-pointensity on both T1- and T2-weighted imaging. However, colonoscopic ultrasonography-assisted needle aspiration biopsy could not specify tumor characteristics. From these examinations, the lesion was diagnosed as sigmoid colon endometriosis and laparoscopy-assisted sigmoidectomy was performed. Pathological diagnosis from the resected specimen was identical to preoperative diagnosis, i.e., colonic endometriosis. Since differential diagnosis of intestinal endometriosis seems difficult, a cautious preoperative diagnosis is required to select treatments including minimally invasive surgery.

摘要

我们报告一例乙状结肠子宫内膜异位症女性患者,术前得到正确诊断并接受了微创手术。她因直肠出血和便秘入院。我们进行了多项检查。结肠镜检查和内镜超声显示乙状结肠狭窄由黏膜下肿瘤引起,磁共振成像显示乙状结肠肿瘤在T1加权成像和T2加权成像上均表现为信号低强度。然而,结肠镜超声引导下针吸活检无法明确肿瘤特征。根据这些检查,该病变被诊断为乙状结肠子宫内膜异位症,并进行了腹腔镜辅助乙状结肠切除术。切除标本的病理诊断与术前诊断一致,即结肠子宫内膜异位症。由于肠道子宫内膜异位症的鉴别诊断似乎很困难,因此需要谨慎的术前诊断以选择包括微创手术在内的治疗方法。

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