A Rare Case of Acute Mechanical Intestinal Obstruction: Colonic Endometriosis [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. Ahead of Print: UTD-62705 | DOI: 10.5505/tjtes.2018.62705  

A Rare Case of Acute Mechanical Intestinal Obstruction: Colonic Endometriosis

Mehmet Zeki Buldanlı1, İbrahim Ali Özemir2, Oktay Yener2, Yasemin Dölek3
1Çankırı State Hospital, General Surgery Clinic, Çankırı, Turkey
2İstanbul Medeniyet University, Göztepe Training and Research Hospital, İstanbul, Turkey
3Çankırı State Hospital, Medical Pathology Clinic, Çankırı, Turkey

Endometriosis is a disease seen in women at reproductive age, characterised by extrauterin localisation of endometrial tissue. Colonic endometriosis rarely causes acute mechanical intestinal obstruction(AMIO) as well as it can be presented with pelvic pain, dyspareunia, tenesmus, painful defecation related with menstrual cycle. In the literature 3-37% gastrointestinal location was reported and AMIO was observed in 7-23% of these cases. There are only a few cases of mechanical obstruction related with sigmoid endometriosis mimicking colon malignancy. In this paper our purpose was to report a case of a 40-year-old patient with AMIO developed secondary to colonic endometriosis with review of literature. The patient was discharged with full surgical recovery after Hartmann procedure was performed and pathological diagnosis was determined as endometriosis. At post operative sixth month colostomy closure and bilateral oophorectomy was performed with patient’s will. The patient was discharged with surgical recovery and is still regularly followed up. Endometriosis is a gynecological disease that can occur in all organ systems even though the most common location is the overs. Gastrointestinal located endometriosis should therefore be kept in mind in the etiology of AMIO in women at reproductive age and the related symptoms should be questioned in differencial diagnosis.

Keywords: endometriosis, ileus, acute mechanical intestinal obstruction


Nadir Görülen Bir Akut Mekanik İntestinal Obstrüksiyon Olgusu: Kolonik Endometriozis

Mehmet Zeki Buldanlı1, İbrahim Ali Özemir2, Oktay Yener2, Yasemin Dölek3
1Çankırı Devlet Hastanesi, Genel Cerrahi Kliniği, Çankırı
2İstanbul Medeniyet Üniversitesi, Göztepe Eğitim ve Araştırma Hastanesi, İstanbul
3Çankırı Devlet Hastanesi, Tıbbi Patoloji Kliniği, Çankırı

Endometriozis; üreme çağı kadınlarda görülen, endometrium dokusunun uterus dışında yer alması ile karakterize bir hastalıktır. Kolonik endometriozis menstrual siklusla ilişkili pelvik ağrı, disparoni, tenesmus ve ağrılı dışkılama şikayetleri ile ortaya çıkabildiği gibi, nadiren akut mekanik intestinal obstrüksiyona (AMIO) da yol açabilmektedir. Literatürde %3-37 oranında gastrointestinal yerleşim bildirilmiş olup bu olguların da %7-23'ünde AMIO kliniği bildirilmiştir. Literatürde kolon malignitesini taklit eden sigmoid endometriozise bağlı az sayıda mekanik obstrüksiyon vakası bulunmaktadır. Biz de kolonik endometriozise sekonder olarak gelişen AMIO saptanan 40 yaşındaki kadın hastayı literatür eşliğinde sunmayı amaçladık. Hartmann prosedürü uygulanan ve cerrahi şifa ile taburcu edilen hastada patolojik incelemede endometriozis tespit edildi. Post operatif 6. ayda kolostomi kapatılması ve kendi isteğiyle bilateral ooferektomi operasyonu uygulanan hastanın takipleri devam etmektedir. Endometriozis tüm organları tutabilen jinekolojik bir hastalık olup gastrointestinal yerleşimi AMIO etyolojisinde özellikle reprodüktif dönemdeki kadın hastalarda akılda tutulmalı ve ilişkili semptomlar sorgulanmalıdır.

Anahtar Kelimeler: endometriozis, ileus, akut mekanik intestinal obstrüksiyon




Corresponding Author: Mehmet Zeki Buldanlı, Türkiye


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