[Intestinal obstruction caused by abdominal pseudotumoral endometriosis mimicking a peritoneal carcinomatosis--case report].
A 40-year-old woman was admitted in emergency condition with the symptomatology of bowel obstruction. Intraoperative findings consists of a pelvic fixed tumoral mass, and numerous other tumors spread in the whole abdominal cavity mimicking a peritoneal carcinomatosis without liver metastases. Three of the tumors where about 4 cm in diameter producing stenosis of the terminal ileurn and sigma. We considered the case as it was a peritoneal carcinomatosis caused by an uterus or ovarian cancer and we decided for palliative surgery, performing ileo-transversostomy and sigmoidostomy above the obstruction. The histopathologic findings from more pieces of tumors revealed endometriosis without cancerous changes. Postoperative the patient underwent cytostatic and then hormonal therapy. After 3 month the CT scan revealed an important reducing in volume of the pelvic tumoral mass and the barium enema didn't showed any stenosis under the colostomy so, we closed it extraperitonealy. At 16 month after the first operation the patient was reoperated for a parietal defect. At the second look we found no tumors. The pelvic tumoral mass has disappeared, the uterus seemed to be normal but two big ovary cysts were present. We performed bilateral adnexectomy and the repair of the parietal defect. Postoperative evolution was favorable without any complication or complains at 3 month after the last operation.
Clinica Chirurgie 1 Tg.-Mureş, Spitalul Clinic Judeţean Mureş. tomaion@orizont.net
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D000328:Adult; D001706:Biopsy; D002277:Carcinoma / Q000150:complications* / Q000601:surgery; D004715:Endometriosis / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery; D010532:Peritoneal Diseases / Q000150:complications* / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome