[Intestinal invagination due to endometriosis of the terminal ileum].
METHODS
A 39 year old female patient presented with nausea and crampy abdominal pain in the right lower quadrant.


METHODS
Physical examination showed a markedly distended abdomen with a diffuse pain, punctum maximum in the right lower part of the abdomen and reduced peristalsis. Plain abdominal x-rays revealed slightly dilated loops of small bowel with air-fluid levels. Abdominal ultrasound revealed thickening of the bowel wall of the distal ileum and some free fluid. To exclude Crohn's disease, Sellink-computer tomography was performed, which also showed thickening of the wall of the terminal ileum and dilated bowel loops proximal to the underlying stenosis.


METHODS
Intraoperatively, the terminal ileum was thickened by scar tissue and subtotally invaginated. Histologic investigation of the resected specimen showed submucosal endometriosis.


CONCLUSIONS
Endometriosis of the small bowel should be considered carefully in the differential diagnosis of female patients of reproductive age who suffer from symptoms of ileus, dysmenorrhea and sterility.
Mittermair
R P
RP
Universitätsklinik für Chirurgie, Universität Innsbruck. reinhard.mittermair@tirol.com
Prommegger
R
R
Zelger
B G
BG
Bodner
E
E
D000328:Adult; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000150:complications* / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D007082:Ileum / Q000473:pathology / Q000601:surgery; D007443:Intussusception / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery