Abstract
The sigmoid colon, and rectum are major sites of endometriosis development, but in contrast, small intestinal endometriosis is rare. We encountered a case of endometriosis of the ileum with endosalpingiosis in the regional lymph node treated surgically because of recurrent bowel obstructive symptoms. A 50-year-old woman presented with recurrent bouts of bowel obstruction, the cause of which could not be determined through multiple evaluations. She was re-hospitalized because of recurrent abdominal distension. Although an abdominal computed tomography revealed a suspected tumorous lesion in the terminal ileum and dilated small bowel, we could not determine the final diagnosis. Exploratory laparotomy was performed for recurrent bowel obstruction. Serosa of the terminal ileum exhibited scarring with induration, resulting in bowel obstruction, and ileocecal resection was performed. Histological examination revealed glandular structures of various sizes comprising cubical and columnar epithelium surrounded by spindle cells from the subserosal to submucosal layers of the ileum. As we observed glandular structures comprising cubical epithelium in the regional lymph node, we diagnosed the case as bowel obstruction caused by endometriosis of the ileum with metastatic involvement of endosalpingiosis in the regional lymph node.
