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直肠子宫内膜异位症致梗阻的全面外科治疗:病例报告及文献复习。

Comprehensive surgical treatment for obstructive rectal endometriosis: a case report and review of the literature.

机构信息

Department of Radiation Oncology Center, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou, 221006, Jiangsu, People's Republic of China.

Department of Gastrointestinal Surgery, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou, 221006, Jiangsu, People's Republic of China.

出版信息

BMC Womens Health. 2022 Jul 7;22(1):280. doi: 10.1186/s12905-022-01858-z.

Abstract

BACKGROUND

Intestinal obstruction caused by endometriosis maybe easily misdiagnosed as a tumor or other occupying disease in emergency condition. How to deal with it depending on the clarity of the preoperative diagnosis and the experience of the surgeon.

CASE PRESENTATION

A 47-year-old woman, admitted to our emergency service with abdominal pain and distension for 5 days, anal stop exhausting and defecating for 3 days. Based on imaging and laboratory examination, we made a preoperative diagnosis of rectal endometriosis probably. After 7 days of colon decompression with a intestinal obstruction catheter, an operation of laparoscopic partial rectal and sigmoid resection without protective stoma and total hysterectomy was performed successfully. The patient obtained a smooth postoperative course and doing well after 12-weeks follow up.

CONCLUSIONS

Obstruction caused by rectal endometriosis is very rare and easily overlooked by surgeon and gynecologist. Appropriate preoperative diagnosis and preoperative management can reduce the trauma and incidence of complications.

摘要

背景

子宫内膜异位症引起的肠梗阻在急诊时可能很容易被误诊为肿瘤或其他占位性疾病。如何处理取决于术前诊断的清晰度和外科医生的经验。

病例介绍

一名 47 岁女性,因腹痛和腹胀 5 天,肛门停止排气排便 3 天就诊于我院急诊。根据影像学和实验室检查,我们术前诊断为直肠子宫内膜异位症可能。在肠梗阻导管进行结肠减压 7 天后,成功地进行了腹腔镜下直肠和乙状结肠部分切除而无保护性造口术和全子宫切除术。患者术后恢复顺利,12 周随访时情况良好。

结论

直肠子宫内膜异位症引起的肠梗阻非常罕见,容易被外科医生和妇科医生忽视。适当的术前诊断和术前处理可以减少创伤和并发症的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e30/9260976/b61e976e104e/12905_2022_1858_Fig1_HTML.jpg

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