A Case of Intestinal Endometriosis with Repeated Ileal Obstruction That Was Treated Laparoscopic Resection

Abstract

Intestinal endometriosis is found in more than 10％ of women with endometriosis. Intestinal endometriosis involving the ileum, while rare, is sometimes known to cause bowel obstruction. The patient was a 35-year-old woman with no prior history of surgery. She gave a history of having been hospitalized twice earlier for bowel obstruction and further examinations were scheduled for the outpatient department, but since the patient developed abdominal pain, she was admitted to our department. A diagnosis of intestinal endometriosis was made on the basis of the findings of MRI. Laparoscopic surgery was performed. Endometriosis of the right ovary and hemorrhagic ascites associated with menstruation were confirmed. A similar lesion was identified 10 cm distal to the terminal ileum, and partial resection of the small intestine was performed. Histopathological examination of the resected specimen showed the presence of endometrial tissue within the subserosal and muscular layers, with fibrosis and bleeding. Intestinal endometriosis must be borne in mind as a possible cause in women of reproductive age presenting with small bowel obstruction. MRI is useful for diagnosing intestinal endometriosis and extensive observation was possible by laparoscopic surgery in our case.