Deutsche medizinische Wochenschrift (1946) · 1999
[Intestinal invagination due to endometriosis of the terminal ileum].
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Mittermair R P, Prommegger R, Zelger B G, Bodner E
Аннотация
HISTORY AND CLINICAL FINDINGS: A 39 year old female patient presented with nausea and crampy abdominal pain in the right lower quadrant.
INVESTIGATIONS: Physical examination showed a markedly distended abdomen with a diffuse pain, punctum maximum in the right lower part of the abdomen and reduced peristalsis. Plain abdominal x-rays revealed slightly dilated loops of small bowel with air-fluid levels. Abdominal ultrasound revealed thickening of the bowel wall of the distal ileum and some free fluid. To exclude Crohn's disease, Sellink-computer tomography was performed, which also showed thickening of the wall of the terminal ileum and dilated bowel loops proximal to the underlying stenosis.
DIAGNOSIS, TREATMENT AND COURSE: Intraoperatively, the terminal ileum was thickened by scar tissue and subtotally invaginated. Histologic investigation of the resected specimen showed submucosal endometriosis.
CONCLUSION: Endometriosis of the small bowel should be considered carefully in the differential diagnosis of female patients of reproductive age who suffer from symptoms of ileus, dysmenorrhea and sterility.
INVESTIGATIONS: Physical examination showed a markedly distended abdomen with a diffuse pain, punctum maximum in the right lower part of the abdomen and reduced peristalsis. Plain abdominal x-rays revealed slightly dilated loops of small bowel with air-fluid levels. Abdominal ultrasound revealed thickening of the bowel wall of the distal ileum and some free fluid. To exclude Crohn's disease, Sellink-computer tomography was performed, which also showed thickening of the wall of the terminal ileum and dilated bowel loops proximal to the underlying stenosis.
DIAGNOSIS, TREATMENT AND COURSE: Intraoperatively, the terminal ileum was thickened by scar tissue and subtotally invaginated. Histologic investigation of the resected specimen showed submucosal endometriosis.
CONCLUSION: Endometriosis of the small bowel should be considered carefully in the differential diagnosis of female patients of reproductive age who suffer from symptoms of ileus, dysmenorrhea and sterility.