乙状结肠内子宫内膜异位症/生殖器外子宫内膜异位症。

T. Acar, N. Acar, S. C. Çelik, N. Ekinci, E. Tarcan, E. Çapkınoğlu
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引用次数: 11

摘要

子宫内膜异位症是指子宫腔外存在子宫内膜腺体和间质。虽然在育龄妇女中很常见,但肠道子宫内膜异位症极为罕见,可能导致严重的临床问题。本文报告两例罕见的乙状结肠内腔子宫内膜异位症。第一位病例为45岁女性,主诉直肠出血6个月。结肠镜检查发现息肉样病变疑似恶性肿瘤,大小为3-4厘米。由于腹腔镜前切除术不适合结肠镜息肉切除术,我们选择了腹腔镜前切除术。病理检查发现子宫外子宫内膜异位症。第二例为36岁女性,因下腹痛和直肠出血住院3个月。她被诊断为乙状结肠憩室炎。患者经药物治疗后症状有所缓解,但由于早期和多次复发,我们决定进行择期腹腔镜前切除术。病理报告指出大肠憩室病和腔内子宫内膜异位症。对于出现便秘、消化道出血、恶心、呕吐、痉挛样腹痛、腹泻和盆腔疼痛的育龄女性患者,应将肠子宫内膜异位症作为鉴别诊断的一部分。在这些患者中,切除和吻合受影响的肠段被接受为治疗的选择。
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Endometriosis within the sigmoid colon/extragenital endometriosis.
Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity. Although it is common in women in the reproductive age, intestinal endometriosis is extremely rare and may lead to serious clinical problems. In this article, we present two rare cases of endometriosis localized in the sigmoid colon lumen. The first case is a 45 year-old female complaining of rectal bleeding for 6 months. A polypoid lesion with suspicion of malignancy, 3-4 cm in size was identified at colonoscopy. Laparoscopic anterior resection was performed since it was not suitable for colonoscopic polypectomy. The pathology examination revealed extragenital endometriosis. The second case is a 36 year-old female admitted for lower abdominal pain and rectal bleeding for the last 3 months. She was diagnosed with sigmoid diverticulitis. The patient's symptoms regressed with medical treatment, but due to early and multiple recurrent episodes it was decided to perform an elective laparoscopic anterior resection. The pathology report stated diverticulosis coli and intraluminal endometriosis. Intestinal endometriosis should be considered as part of the differential diagnosis in female patients of the reproductive age who present with constipation, gastrointestinal bleeding, nausea, vomiting, cramp-like abdominal pain, diarrhea and pelvic pain. In these patients, resection and anastomosis of the effected bowel segment is accepted as the choice of treatment.
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