Santos-Manzur A, Valdez-Bocanegra DR, Ornelas-Flores MC, Pineda-Díaz J, Stoopen-Margain E. Ileal obstruction caused by transmural endometriosis in a patient with simultaneous C. difficile colitis and Influenza AH1N1. Case report.
Int J Surg Case Rep 2020;
76:522-525. [PMID:
33207423 PMCID:
PMC7596015 DOI:
10.1016/j.ijscr.2020.10.039]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 11/04/2022] Open
Abstract
Bowel obstruction or intestinal occlusion caused by endometriosis is very rare.
Endometriotic nodules induce luminal stenosis and ileal obstruction.
Transmural endometriosis infiltrates the four layers of the intestinal wall.
Diagnosis is established through pathological and immunohistochemical analysis.
The treatment of choice is bowel resection via laparoscopy or laparotomy.
Introduction
Small bowel obstruction secondary to endometriosis is extremely rare. This etiology is reported in 0.10% of cases and diagnosed incidentally.
Case presentation
32-year old female, critically ill patient was diagnosed with small bowel obstruction. After medical stabilization of multiple comorbidities, diagnostic laparoscopy was done and converted to open right ileocolectomy with ileo-transverse anastomosis. Definite diagnosis was ileal obstruction caused by transmural endometriosis. The patient's recovery was uneventful. At one-year follow-up, she remains asymptomatic.
Discussion
We present the uncommon case of ileal obstruction due to transmural endometriosis that was treated surgically. We also present current literature review focusing on diagnostic and treatment methods of this rare disease.
Conclusion
Endometriosis should be included in the differential diagnosis of small bowel obstruction. The treatment of choice is bowel resection.
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