Levitt M D, Hodby K J, van Merwyk A J, Glancy R J
Department of Surgery, Fremantle Hospital, Western Australia.
Aust N Z J Surg. 1989 Dec;59(12):941-3. doi: 10.1111/j.1445-2197.1989.tb07635.x.
Three case reports of cyclical rectal bleeding in endometriosis affecting rectum and sigmoid colon emphasize the close relationship between such cyclical bleeding and intestinal endometriosis. The cause of bleeding, however, is still unclear. The predilection of endometriotic deposits for the outer layers of the bowel wall suggests that mucosal involvement is not a prerequisite for rectal bleeding. The frequent absence of identifiable intramural haemorrhage casts doubt on the premise that intestinal endometriotic deposits 'menstruate'. The cause may simply be a transient tear in normal mucosa due to swelling of an underlying endometriotic deposit at the time of menstruation.
三例子宫内膜异位症累及直肠和乙状结肠导致周期性直肠出血的病例报告强调了这种周期性出血与肠道子宫内膜异位症之间的密切关系。然而，出血原因仍不明确。子宫内膜异位灶倾向于沉积在肠壁外层，这表明黏膜受累并非直肠出血的必要条件。经常无法识别壁内出血，这对肠道子宫内膜异位灶“月经来潮”这一前提提出了质疑。原因可能仅仅是在月经期间，潜在的子宫内膜异位灶肿胀导致正常黏膜出现短暂撕裂。
