The Feasibility of MRI for Small Bowel Obstruction Because of Ileal Endometriosis. Two Case Reports

Abstract

Since digestive tract disorder associated with intestinal obstruction includes various diseases such as malignant tumor and benign disease, preoperative diagnosis is important to decide the treatment strategy. In particular, when treating a benign disease such as endometriosis of ileum presenting primary symptoms of intestinal obstruction, performing minimally invasive surgery is encouraged despite the difficulty of preoperative diagnosis. When diagnostic imaging of intestinal obstruction is urgently needed, CT and gastrointestinal contrast examination are usually used but MRI is seldom performed. MRI of intestinal endometriosis characteristically shows a dotted high intensity area on fat suppressed T1-weighted image and a markedly low intensity area on T2-weighted image. When treating intestinal obstruction of premenopausal women, therefore, MRI prior to inserting an ileus tube enables preoperative diagnosis of endometriosis of the ileum, which is expected to realize minimally invasive treatment.

In this study, we report two cases of women in their 40ʼs who were suspected of endometriosis of ileum presenting primary symptoms of intestinal obstruction and underwent MRI; based on the preoperative definitive diagnosis of endometriosis of the ileum, we opted to perform laparoscopic reduction of intestinal obstruction and the patients had an uneventful postoperative course thereafter.