结肠子宫内膜异位症和结肠周围淋巴结表现为盲肠溃疡

IF 0.6 Q4 GASTROENTEROLOGY & HEPATOLOGY ACG Case Reports Journal Pub Date : 2024-08-22 eCollection Date: 2024-08-01 DOI:10.14309/crj.0000000000001465
Frank Lin, Janak Bahirwani, Lisa Stoll, Sarina Kapoor
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引用次数: 0

摘要

子宫内膜异位症以子宫内膜组织异位种植为特征,通常累及盆腔结构,但很少扩展到盆腔外部位,如胃肠道。在本报告中,我们介绍了一例 44 岁女性的病例,她患有弥漫性腹部不适和便秘。计算机断层扫描成像显示盲肠内有肿块,因此进行了诊断性结肠镜检查和随后的磁共振成像检查。最终,腹腔镜检查发现了一个皱缩的盲肠肿块,怀疑是浸润性恶性肿瘤,但病理证实为累及结肠壁和结肠周围淋巴结的广泛子宫内膜异位症。继发于子宫内膜异位症的盲肠肿物极为罕见,手术是主要的治疗方式。与子宫内膜异位症相关的胃肠道受累常常被伪装成肠易激综合征,这突出了考虑年轻女性非典型表现的重要性。本病例强调,对于有胃肠道症状和非典型影像学检查结果的患者,有必要高度怀疑不寻常的病因,以便及时诊断和治疗。
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Endometriosis of the Colon and Pericolic Lymph Nodes Presenting as Cecal Volvulus.

Endometriosis, characterized by the ectopic implantation of endometrial tissue, typically involves pelvic structures but infrequently extends to extrapelvic sites such as the gastrointestinal tract. In this report, we present a case of a 44-year-old woman with diffuse abdominal discomfort and constipation. Computed tomography imaging revealed a mass in the cecum, leading to diagnostic colonoscopy and subsequent magnetic resonance imaging. Ultimately, laparoscopy revealed a puckered cecal mass suspected to be invasive malignancy but pathologically confirmed as extensive endometriosis involving the colonic wall and pericolic lymph nodes. Cecal volvulus secondary to endometriosis is exceedingly rare, with surgical intervention being the primary treatment modality. Endometriosis-associated gastrointestinal involvement often masquerades as irritable bowel syndrome, highlighting the importance of considering atypical presentations in young women. This case underscores the need to maintain a high index of suspicion for unusual etiologies in patients with gastrointestinal symptoms and atypical imaging findings to facilitate timely diagnosis and management.

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来源期刊
ACG Case Reports Journal
ACG Case Reports Journal GASTROENTEROLOGY & HEPATOLOGY-
自引率
14.30%
发文量
170
审稿时长
12 weeks
期刊介绍: ACG Case Reports Journal is a peer-reviewed, open-access publication that provides GI and hepatology fellows, private practice clinicians, and other healthcare providers an opportunity to share interesting case reports with their peers and with leaders in the field. ACG Case Reports Journal publishes case reports, images, videos and letters to the editor in all topics of gastroenterology and hepatology, including: Biliary Colon Endoscopy Esophagus Functional Bowel Disorders Inflammatory Bowel Disease Liver Nutrition and Obesity Pancreas Pathology Pediatric Small Bowel Stomach.
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