A case report of endometriosis presenting as an acute small bowel obstruction
| Autor: | Daniel L. Chan, Marisol Perez Cerdeira, Praveen Ravindran, Dorothy Chua, Isabella Mor |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Endometriosis urologic and male genital diseases Article Resection 03 medical and health sciences 0302 clinical medicine Case report Medicine Laparoscopy Gastrointestinal tract 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry General surgery Small bowel obstruction Emergency department medicine.disease Surgery Bowel obstruction 030220 oncology & carcinogenesis Childbearing age Presentation (obstetrics) business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2017.09.024 |
| Popis: | Highlights • Endometriosis causing acute small bowel obstruction is rare. • Maintain clinical suspicion for pre-menopausal females with obstructive symptoms. • Early laparoscopy in such cases is diagnostic and therapeutic. Introduction Endometriosis is a common and benign condition that causes significant morbidity to women of childbearing age. It uncommonly affects the gastrointestinal tract and rarely manifests as an acute small bowel obstruction. Presentation of case A 46-year old female presented to the emergency department with signs and symptoms consistent with an acute small bowel obstruction. She had a paucity of background surgical history, having only had a laparoscopic cholecystectomy. Her CT demonstrated small bowel obstruction with a transition point in the distal ileum. Given the site of obstruction was remote from previous surgery, a high index of suspicion was maintained and early laparoscopy performed the same day. Operative findings were consistent with an endometrial stricture of the distal ileum and a formal resection was performed. Discussion Endometriosis that affects the gastrointestinal tract often presents with non-specific symptoms. This is a rare case of an acute small bowel obstruction as the index symptom of endometriosis in a peri-menopausal patient. This is the first case in the literature to describe same day laparoscopy and small bowel resection of such a case and a prolonged preoperative period and misdiagnoses previously described were avoided due to clinical suspicion. Conclusion Endometriosis as a differential should be considered with a high index of suspicion in pre-menopausal women, particularly in patients with negligible previous surgical history. There should be a low threshold for early laparoscopy and resection of affected bowel in these patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|