Sassi Selim, Bouassida Mahdi, Touinsi Hassen, Mongi Mighri Mohamed, Baccari Sonia, Chebbi Fathi, Bouzeidi Khaled, Sassi Sadok
Department of surgery, Mohamed Thahar Maamouri Hospital, Nabeul, Tunisia.
Pan Afr Med J. 2011;10:33. Epub 2011 Nov 8.
Endometriosis with intestinal serosal involvement is not uncommon in women of childbearing age. However, endometriosis presenting as colon obstruction is rare and occurs in less than 1% of cases. The Lack of pathognomonic signs makes the diagnosis difficult, mostly because the main differential diagnosis is with neoplasm, even during the intervention. Reported here is a case of a 35-year -old woman presenting with bowel obstruction due to rectal endometriosis. The patient presented signs and symptoms of bowel obstruction. Colonoscopy and radiological findings were suggestive of rectal carcinoma. Surgeons performed an anterior resection with right salpingectomy. Histopathology diagnosed bowel endometriosis. This case demonstrates the difficulty of establishing an accurate pre- and intra- operative diagnosis and the ability of intestinal endometriosis to mimic colon cancer.
子宫内膜异位症累及肠浆膜在育龄女性中并不少见。然而,以结肠梗阻为表现的子宫内膜异位症较为罕见,发生率不到1%。由于缺乏特征性体征,诊断较为困难,主要原因是即使在手术过程中,主要的鉴别诊断也是与肿瘤进行区分。本文报告一例35岁女性因直肠子宫内膜异位症导致肠梗阻的病例。患者出现肠梗阻的体征和症状。结肠镜检查和影像学检查结果提示直肠癌。外科医生进行了前切除术并切除右侧输卵管。组织病理学诊断为肠道子宫内膜异位症。该病例表明术前和术中准确诊断存在困难,以及肠道子宫内膜异位症可酷似结肠癌。