Ishii Masatsugu, Yamamoto Masashi, Tanaka Keitaro, Asakuma Mitsuhiro, Masubuchi Shinsuke, Hamamoto Hiroki, Akutagawa Hiroshi, Egashira Yutaro, Hirose Yoshinobu, Okuda Junji, Uchiyama Kazuhisa
Departments of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan.
Department of Pathology, Osaka Medical College, Osaka, Japan.
J Med Case Rep. 2018 Jan 30;12(1):21. doi: 10.1186/s13256-017-1537-3.
Intestinal endometriosis is a common benign disease among menstruating women that affects the intestinal tract.
This case report presents seven Japanese cases of intestinal endometriosis with colorectal cancer treated by laparoscopic surgery. Five of the seven cases reported here are women presenting with bowel obstruction due to colorectal endometriosis with colorectal cancer. It can be confused with serious lesions such as advanced colorectal cancer with peritoneal involvement or invasion of adjacent organs (T4).
Therefore, we should consider the probability that the cause of bowel obstruction is not T4 but intestinal endometriosis. For surgical treatment, we recommend laparoscopic surgery for colorectal resection because of its benefits of differential diagnosis of T4, preserving fertility, and preventing excessive surgical stress. We performed laparoscopic resection in seven patients with intestinal endometriosis and colorectal cancer. These cases demonstrate the difficulty of establishing a differential diagnosis of intestinal endometriosis with colorectal cancer from T4.
肠道子宫内膜异位症是一种在有月经的女性中常见的影响肠道的良性疾病。
本病例报告展示了7例接受腹腔镜手术治疗的合并结直肠癌的日本肠道子宫内膜异位症病例。此处报告的7例病例中有5例是因结直肠子宫内膜异位症合并结直肠癌而出现肠梗阻的女性。它可能会与诸如伴有腹膜受累或侵犯相邻器官（T4）的晚期结直肠癌等严重病变相混淆。
因此，我们应考虑肠梗阻的病因不是T4而是肠道子宫内膜异位症的可能性。对于手术治疗，由于其在鉴别T4、保留生育能力和避免过度手术应激方面的益处，我们推荐采用腹腔镜手术进行结直肠切除。我们对7例肠道子宫内膜异位症合并结直肠癌患者进行了腹腔镜切除。这些病例表明从T4鉴别肠道子宫内膜异位症与结直肠癌存在困难。
