A Case of Endometriosis of the Ileum Causing Intestinal Obstruction

Toshinori Ishii, Yasuhiro Okamoto

Department of Surgery, Mitaka Central Hospital

A case of ileal endometriosis presenting with ileus is reported. The case was a 35-year-old woman who had abdominal pain at menstruation. In March 1991 she was hospitalized as an emergency patient because of intestinal obstruction. After decompression of the intestinal tract with an ileus tube, enterography revealed a stenotic shadow at the terminal ileum. The preoperative diagnosis was endometriosis involving the ileum, and ileocecal resection and right salpingo-oophorectomy were performed. Histological evaluation confirmed intramural endometriosis. Ileal endometriosis is so rare that only 25 cases have so far been reported in Japan. The clinical diagnosis of intestinal endometriosis begins with a high index of suspicion based on the patient's history and frequently associated gynecologic symptoms. Intestinal involvement by endometriosis to the degree that it produces symptoms almost always requires excision. We should keep in mind endometriosis of the small intestine as the underlying disease of intestinal obstruction.

Key words
intestinal obstruction, ileal endometriosis

Reprint requests
Toshinori Ishii Department of Surgery, Mitaka Central Hospital
5-23-10, Kamirenjaku, Mitaka, 181 JAPAN

Accepted
April 1, 1992

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