Abstract
We report a case of ileocecal endometriosis accompanied by frequent episodes of intestinal obstruction associated with menstruation during observation for ovarian endometriomas. The clinical diagnosis was confirmed on endoscopic surgery. The patient was 40-year-old woman, gravid 0, para 0. She initially presented at the emergency department of our hospital because of dysmenorrhea. Ovarian endometriomas were detected at initial examination, and either surgery or drug therapy was recommended, but the patient declined treatment and was observed. Thereafter, frequent episodes of intestinal obstruction occurred, coinciding with monthly menstruation during follow-up. Diagnostic endoscopic surgery was performed after receiving informed consent from the patient. Strong adhesions were found in the ileocecum and were regarded to be the cause of the obstructions. The ileocecum was resected along with the ovarian endometriomas. Pathological examination confirmed that these adhesions had been caused by ileocecal endometriosis. Endometriosis is a frequent cause of dysmenorrhea, and the majority of cases are diagnosed and treated by gynecologists. However, when endometriosis involves portions of the small intestine such as the ileocecum, such as in our patient, internists are often initially consulted for symptoms of intestinal obstruction, and surgical treatment requires collaboration with a general surgeon. This case highlights the need for multi-departmental cooperation in the diagnosis and treatment of ileocecal endometriosis.
