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子宫内膜异位症:大肠梗阻的罕见病因。

Endometriosis: A Rare Cause of Large Bowel Obstruction.

作者信息

Alexandrino Gonçalo, Lourenço Luís Carvalho, Carvalho Rita, Sobrinho Cisaltina, Horta David Valadas, Reis Jorge

机构信息

Gastroenterology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal.

General Surgery Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal.

出版信息

GE Port J Gastroenterol. 2018 Mar;25(2):86-90. doi: 10.1159/000480707. Epub 2017 Oct 5.

Abstract

Large bowel obstruction can result in significant morbidity and mortality, especially in cases of acute complete obstruction. There are many possible causes, the most common in adults being colorectal cancer. Endometriosis is a benign disease, and the most affected extragenital location is the bowel, especially the rectosigmoid junction. However, transmural involvement and acute occlusion are very rare events. We report an exceptional case of acute large bowel obstruction as the initial presentation of endometriosis. The differential diagnosis of colorectal carcinoma may be challenging, and this case emphasizes the need to consider intestinal endometriosis in females at a fertile age presenting with gastrointestinal symptoms and an intestinal mass causing complete large bowel obstruction.

摘要

大肠梗阻可导致严重的发病率和死亡率,尤其是在急性完全性梗阻的情况下。其病因众多,在成人中最常见的是结直肠癌。子宫内膜异位症是一种良性疾病,最常累及的生殖器外部位是肠道,尤其是直肠乙状结肠交界处。然而,透壁性受累和急性梗阻非常罕见。我们报告了一例以急性大肠梗阻为子宫内膜异位症首发表现的特殊病例。结直肠癌的鉴别诊断可能具有挑战性,该病例强调了对于出现胃肠道症状且有导致完全性大肠梗阻的肠道肿块的育龄女性,需要考虑肠道子宫内膜异位症。

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Eur J Obstet Gynecol Reprod Biol. 2017 Feb;209:3-7. doi: 10.1016/j.ejogrb.2016.04.021. Epub 2016 Apr 30.
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Endometriosis: pathogenesis and treatment.子宫内膜异位症:发病机制与治疗。
Nat Rev Endocrinol. 2014 May;10(5):261-75. doi: 10.1038/nrendo.2013.255. Epub 2013 Dec 24.
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Endoscopic management of refractory benign colorectal strictures.难治性良性大肠狭窄的内镜治疗
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Complications of colorectal anastomoses: leaks, strictures, and bleeding.结直肠吻合口并发症:漏、狭窄和出血。
Surg Clin North Am. 2013 Feb;93(1):61-87. doi: 10.1016/j.suc.2012.09.014. Epub 2012 Oct 27.

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