A case of small intestinal endometriosis with perforation

Abstract

We report a case of small intestinal endometriosis with perforation. A 42-year-old female was admitted to the hospital because of abdominal pain. She had been treated with endocrine therapy for suspected small intestinal endometriosis since 2 years earlier and had had several boats of intestinal obstruction treated conservatively. This time no etiologic lesion was identified by close exploration, but she developed perforative peritonitis. Emergency operation was thus performed. Operative findings showed perforation of the ileum at a part of 5cm distal from the ileum end, and ileo-cecal resection was performed. Resected specimen revealed endometrial glands and fibrotic change in the all layer of the ileum and the pathological diagnosis was endometriosis of the ileum. Endometriosis can occur in various sites of the entire gastrointestinal tract, but the common sites are the rectum and sigmoid colon and the small intestine is uncommonly involved. Furthermore small intestinal endometriosis commonly presents with intestinal obstruction or anal bleeding and rarely with perforation. We report this case, together with some bibliographical comments.