SMALL BOWEL OBSTRUCTION IN A YOUNG REPRODUCTIVE AGE WOMAN
Keywords:Intestinal endometriosis, acute intestinal obstruction, emergency laparotomy
Endometriosis is a benign condition that can presents as surgical emergency because of its complications. Intestinal endometriosis affects up to 37% of women with endometriosis and it is rare to manifest as an acute small bowel obstruction secondary to ileal endometriosis. Small bowel endometriosis should be considered as a differential diagnosis when assessing females of reproductive age with acute small bowel obstruction. We present the two cases of female patients with intestinal endometriosis who presented with symptoms and signs of an acute small bowel obstruction requiring emergency surgery. A small bowel resection was performed in those cases. Histopathological examination confirmed a diagnosis of endometriosis with fibrosis and stricture of the bowel segment. Endometriosis should be considered in the differential diagnosis of every woman of childbearing age who presents with abdominal symptoms. Clinicians should keep in mind this condition in cases of abdominal emergency in young female patients.
Al-Talib A , Tulandi T. Intestinal endometriosis. Gynecol Surg 2010; 7:61–62
Anaf V, El Nakadi I, Simon P, Van de Stadt J, Fayt I, Simonart T, Noel JC. Preferential infiltration of large bowel endometriosis along the nerves of the colon. Hum Reprod 2004; 19: 996-1002
Audebert AJ. External endometriosis: histogenesis, etiology and natural course. Rev Prat 1990; 40: 1077-1081
Badawy SZ, Freedman L, Numann P, Bonaventura M, Kim S. Endometriosic bowel obstruction 3433 S. Diagnosis and management of intestinal endometriosis. A report of five cases. J Reprod Med 1988; 33: 851-855
Bedaiwy MA, Abdel-Aleem MA, Miketa A, Falcone T. Endometriosis: a critical appaisal of the advances and the contraversies of the challenging health problem. Minerva Ginecol 2009; 61: 285-98.
Beltrán MA, Tapia QTF, Araos HF, Martínez GH, Cruces KS. Ileal endometriosis as a cause of intestinal obstruction. Report of two cases. Rev Med Chil 2006;134:485-90.
Bergqvist A. Different types of extragenital endometriosis: a review. Gynecol Endocrinol 1993; 7: 207-221
Bianchi A, Pulido L, Espín F, Hidalgo LA, Heredia A, Fantova MJ, Muns R, Suñol J. Intestinal endometriosis. Current status. Cir Esp 2007;81:170-6.
Chapron C, Chopin N, Borghese B, Foulot H, Dousset B, Vacher-Lavenu MC, Vieira M, Hasan W, Bricou A. Deeply infiltrating endometriosis: pathogenetic implications of the anatomical distribution. Hum Reprod 2006; 21:1839-45.
De Cegle A, Bilardi C, Blanch S, Picasso M, Di Muzio M, Trimarchi A, Coni M. Acute small bowel obstruction caused by endometriosis: A case report and review of the literature. World Journal of Gastroenterology 2008; 14:3430-3434.
Deneve E, Maillet O, Blanc P, Fabre JM, Nocca D. Ileocecal intussusception due to a cecal endometriosis. J Gynecol Obstet Biol Reprod 2008; 37:796-798.
Garg NK, Bagul NB, Doughan S, Rowe PH: Intestinal endometriosis–a rare cause of colonic perforation. World Journal of Gastroenterology 2009;15:612-4. due to a cecal endometriosis. J Gynecol Obstet Biol Reprod 2008; 37:796-798.
Gregorić P., Doklestić K., Pandurović M., Radenković D., Karadžić B., Raspopović M., Micev M, Ivančević N, Šijački A, Bajec Đ. Distal Ileal Endometriosis as a Cause of Ileus: A Case Report; Srp Arh Celok Lek. 2012;140(3-4): 225-228
Hoang CD, Boettcher AK, Jessurun J, Pambuccian SE, Bullard KM. An unusual rectosigmoid mass: endometrioid adenocarcinoma arising in colonic endometriosis: case report and literature review. The American Surgeon. 2005; 71:694-7.
Hornstein MD, Barbieri RL. Endometriosis. In: Ryan Kistner’s gynecology and women’s health. 7th ed. St. Louis: Mosby; 1999. p. 492–519.
Itoga T, Matsumoto T, Takeuchi H, Yamasaki S, Sasahara N, Hoshi T, Kinoshita K. Fibrosis and smooth muscle metaplasia in rectovaginal endometriosis. Pathol Int. 2003;53:371–375.
Jones KD, Owen E, Berresford A, Sutton C. Endometrial adenocarcinoma arising from endometriosis of the rectosigmoid colon. Gynecol Oncol 2002; 86: 220-2.
Kavallaris A, Köhler C, Kühne-Heid R, Schneider A. Histopathological extent of rectal invasion by rectovaginal endometriosis. Hum Reprod 2003; 18:1323-7.
Nisolle M, Donnez J. Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril 1997;68:585-96.
Pisanu A , Deplano D, Angioni S, Rossano Ambu, Uccheddu A . Rectal perforation from endometriosis in pregnancy: Case report and literature review World J Gastroenterol 2010;16: 648-651
Remorgida V , Ferrero S, Fulcheri E, Ragni N, Martin DC. Bowel Endometriosis: Presentation, Diagnosis, and Treatment. Obstetrical & Gynecological Survey 2007; 62׃ 461-470
Ridha JR, Cassaro S. Small Bowel Obstruction Due to Ileal Endometriosis. Surg Today 2003; 33:944–947
Sampson JA. Intestinal adenomas of the endometrial type: their importance and their relation to ovarian hematomas of endometrial type (perforating hemorrhagic cysts of the ovary). Arch Surg 1922;5:217–80.
Sheikh HA, Krishnamurti U, Bhat Y, Rajendiran S. A 42-year-old woman with a 7-month history of abdominal pain. A, endometriosis involving ileocecal junction and 2 pericolonic lymph nodes; B, intranodal benign glandular inclusions. Arch Pathol Lab Med 2005; 129: 218-221
Siristatidis CS. What have the ‘omics done for endometriosis? Med Sci Monit 2009; 15:116-23.
Slesser A S, Kubba F, Selluet D. Acute small bowel obstruction secondary to intestinal endometriosis, an elusive condition: a case report. World Journal of Emergency Surgery 2010; 5:27
Szucs RA, Turner MA. Gastrointestinal tract involvement by gynecologic diseases. Radiographics 1996,16:1251-70.
Taylor RN, Yu J, Torres PB, Schickedanz AC, Park JK, Mueller MD, Sidell N.Mechanistic and Therapeutic Implications of Angiogenesis in Endometriosis. Reprod Sci 2009;16:140-146.
Teke Z, Aytekin FO, Atalay AO, Demirkan NC. Crohn’s disease complicated by multiple stenoses and internal fistulas mimicking small bowel endometriosis. World Journal of Gastroenterology 2008;14:146-151.
Varras M, Kostopanagiotou E, Katis K, Farantos CH, Angelidou-Manika Z, Antoniou S. Endometriosis causing extensive intestinal obstruction simulating carcinoma of the sigmoid colon: a case report and review of the literature. Eur J Gynaecol Oncol. 2002;23:353-357.
Yantiss RK, Clement PB, Young RH. Endometriosis of the intestinal tract: a study of 44 cases of a disease that may cause diverse challenges in clinical and pathologic evaluation. Am J Surg Pathol 2001; 25: 445-454