[Extragenital endometriosis with multiple stenoses of the small intestine]

Abstract

This paper reports on the case of a 38-year-old woman with multiple stenoses in the proximal and middle section of the jejunum, as well as in the terminal ileum, who had been symptomatic for nine years, with symptoms progressively reflecting obstruction due to mechanical subileus. The cause was found to be extragenital endometriosis which, with the mucosa remaining intact, was associated with hormone-dependent bleeding with subsequent fibrosis leading to segmental thickening of the bowel wall and narrowing of the lumen. The diagnostic work-up included a radiological study of the small bowel as described by Sellingk, abdominal sonography and a CT exam; the X-ray study and the CT scan revealed stenosing of the bowel, while sonography and CT showed wall thickening. The treatment of this condition comprises resection of the affected bowel segment together with anti-estrogen treatment or ovariectomy, and in this respect differs notable from the more common Crohn's disease of the small bowel, from which it must be diagnostically differentiated.