Midorikawa Y, Kubota K, Kubota K, Kawai K, Mori M, Kajiura N
Department of Surgery, Tokyo Seamen's Insurance Hospital, Japan.
Hepatogastroenterology. 1997 May-Jun;44(15):706-9.
A 42-year-old pre-menopausal woman complaining of lower abdominal pain was referred to our hospital. A barium enema showed rectal stenosis and colonoscopy revealed that the mucosa at the stenotic site was normal with no cancerous changes. Pelvic computed tomography demonstrated an adhesion between the rectum and uterus and a thickened rectal wall. The patient underwent exploratory laparotomy under a diagnosis of rectal stenosis. The rectum was found to be surrounded by inflammatory fibrous tissue, which caused the stenosis. As no dissection plane was discernible between the rectum and uterus, low anterior resection of the rectum and hysterectomy were performed. Histological examination showed that endometrial-type glands extended circumferentially around the rectum and invaded the rectal submucosal layer and subsequently, endometriosis of the rectum was diagnosed.
一名42岁的绝经前女性因下腹部疼痛被转诊至我院。钡剂灌肠显示直肠狭窄，结肠镜检查显示狭窄部位的黏膜正常，无癌变。盆腔计算机断层扫描显示直肠与子宫之间有粘连，直肠壁增厚。患者在直肠狭窄的诊断下接受了剖腹探查术。发现直肠被炎性纤维组织包围，导致了狭窄。由于在直肠和子宫之间无法辨别分离平面，遂进行了直肠低位前切除术和子宫切除术。组织学检查显示子宫内膜样腺体围绕直肠呈环形延伸并侵入直肠黏膜下层，随后诊断为直肠子宫内膜异位症。
