A Case of Endometriosis with Repeated Ileal Obstruction Treated by Laparoscopic Surgery

Abstract

A 47-year-old woman visited our emergency department complaining of abdominal pain. Contrast-enhanced computed tomography (CT) showed mechanical bowel obstruction due to wall thickening at the end of the ileum. The patient improved with conservative treatment. Two months after discharge, she visited our hospital again with the same symptom, and a repeat CT showed the same findings. Colonoscopic biopsy of the thickened part of the ileum was performed, however, no definitive diagnosis could be made. Because of the recurrent symptoms of intestinal obstruction, we considered the patient as an eligible candidate for surgery and performed laparoscopic ileocecal resection. The postoperative course was satisfactory and the patient was discharged without any complications. Histopathological examination of the resected specimen revealed evidence of endometriosis and we concluded that the intestinal obstruction was caused by ectopic endometriosis. Endometriosis often occurs in the intestinal tract, sometimes causing bowel obstruction; however, intestinal endometriosis occurring in the ileum is relatively rare and we report this case with a brief review of the literature.