Chiu Tricia, Niranjan Nithya, FitzGerald Kate
Department of Surgery, Wagga Wagga Base Hospital, Docker St Wagga Wagga, NSW 2650, Australia.
J Surg Case Rep. 2023 Jul 3;2023(7):rjad392. doi: 10.1093/jscr/rjad392. eCollection 2023 Jul.
There has been a modest number of cases of bowel obstruction secondary to endometriosis reported. Delays in diagnoses can cause significant morbidity to patients. We describe the case of a 45-year-old female with a 2-year history of recurrent small bowel obstructions (SBOs) without a history of abdominal surgery. She underwent multiple computed tomography scans, and a magnetic resonance enterography, which queried possible terminal ileitis secondary to Crohn's fibro-stenosing disease or a Meckel's diverticulum. Colonoscopy up to TI was normal. Elective laparoscopy showed a cicatrizing small bowel mass in her distal ileum ~15 cm from the TI, which was resected. There were no other findings. Histopathological testing revealed endometriosis. At 2-month post-resection, she remains symptom-free and was referred to gynaecology. Endometriosis causing bowel obstruction should be considered early in female patients, especially those with virgin abdomens. Timely elective laparoscopy is a safe and effective way of diagnosing and treating small bowel obstruction, avoiding an emergency procedure.
据报道，继发于子宫内膜异位症的肠梗阻病例数量不多。诊断延误可给患者带来严重的发病率。我们描述了一名45岁女性的病例，她有2年复发性小肠梗阻（SBO）病史，无腹部手术史。她接受了多次计算机断层扫描和磁共振小肠造影，怀疑可能是克罗恩纤维狭窄病或梅克尔憩室继发的终末回肠炎。直至回肠末端的结肠镜检查正常。择期腹腔镜检查显示在距回肠末端约15厘米的回肠远端有一个瘢痕化小肠肿块，予以切除。未发现其他异常。组织病理学检查显示为子宫内膜异位症。切除术后2个月，她仍无症状，并被转诊至妇科。对于女性患者，尤其是未生育过的女性，应早期考虑子宫内膜异位症导致的肠梗阻。及时进行择期腹腔镜检查是诊断和治疗小肠梗阻的一种安全有效的方法，可避免急诊手术。
