Minocha A, Davis M S, Wright R A
Department of Medicine, University of Louisville School of Medicine, Kentucky.
Dig Dis Sci. 1994 May;39(5):1126-33. doi: 10.1007/BF02087568.
A 35-year-old female presented with recurrent right lower quadrant pain, nausea, and vomiting. She was afebrile with diffuse abdominal tenderness. Plain x-ray of abdomen revealed small bowel obstruction. A barium x-ray of the small bowel showed stricture of the terminal ileum. A CT scan of the abdomen showed a 6-cm mass in right lower quadrant. She was empirically managed as having Crohn's disease. She underwent laparotomy after failure of medical management with high-dose steroids. There was ulceration and narrowing of terminal ileum. Frozen sections revealed endometriosis. Ileocecectomy was performed. Histopathology of resected specimen confirmed the diagnosis of endometriosis, and there was no evidence of chronic inflammatory bowel disease or neoplasia. Ileal endometriosis should be considered in the differential diagnosis of Crohn's disease in menstruating females presenting with perimenstrual symptoms.
一名35岁女性出现反复右下象限疼痛、恶心和呕吐。她无发热，腹部弥漫性压痛。腹部平片显示小肠梗阻。小肠钡剂造影显示回肠末端狭窄。腹部CT扫描显示右下象限有一个6厘米的肿块。她被经验性诊断为克罗恩病。在大剂量类固醇药物治疗失败后，她接受了剖腹手术。发现回肠末端有溃疡和狭窄。冰冻切片显示为子宫内膜异位症。进行了回盲部切除术。切除标本的组织病理学证实了子宫内膜异位症的诊断，且没有慢性炎症性肠病或肿瘤的证据。对于出现经前症状的月经期女性，在克罗恩病的鉴别诊断中应考虑回肠子宫内膜异位症。
