Hall L L, Malone J M, Ginsburg K A
Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA.
Fertil Steril. 1995 Dec;64(6):1204-6. doi: 10.1016/s0015-0282(16)57986-2.
To report a case of intestinal obstruction that developed shortly after preoperative administration of a GnRH analogue (GnRH-a) that caused flare-up and rapid progression of enteric endometriosis.
Case report.
University tertiary reproductive endocrinology practice.
A 34-year-old nulligravid female with progressive severe symptomatic endometriosis.
Planned preoperative administration of GnRH-a for 3 months followed by extirpative surgery and hormone replacement therapy. Instead, total abdominal hysterectomy, bilateral salpingoophorectomy, resection of the obstructed ileocecal junction, and side-to-side ileo-ascending enterocolostomy was performed.
Preoperative GnRH-a administered in the midfollicular phase resulted in flare-up of preexisting ileocecal endometriosis that rapidly progressed, resulting in partial small bowel obstruction.
Gonadotropin-releasing hormone agonist should be used with caution when there is known or suspected enteric endometriosis. Consideration should be given to blocking the agonistic effect of GnRH-a in this setting by the prior or concomitant use of progestins or danazol.
