title: Simultaneous laparoscopic treatment for rectosigmoid and ileal endometriosis.
abstract: Endometriosis is common in women of childbearing age, while severe intestinal endometriosis requiring bowel resection is relatively rare. Intestinal endometriosis has recently been managed laparoscopically. We report the case of a 38-year-old patient with rectosigmoid and ileal endometriosis who was successfully treated by laparoscopic bowel resections. The patient had first presented at age 34 years with a chief complaint of rectal bleeding and lower abdominal pain related to the menstrual cycle. She underwent laparoscopic surgery and was diagnosed with severe endometriosis involving the rectosigmoid colon. Although an additional laparoscopic surgery had been planned, she did not return to the hospital. When she was 38 years old, she presented again with the same symptoms. Magnetic resonance imaging revealed a low intensity mass between the uterus and the rectosigmoid colon. A barium enema showed a stenotic site in the rectosigmoid colon. After hormone therapy, she underwent laparoscopic surgery. The anterior wall of the rectosigmoid colon adhered firmly to the corpus of the uterus, and another stenotic site was identified at the terminal ileum. The rectosigmoid colon and ileum were partially resected under laparoscopy. The postoperative course was uneventful and she was freed of symptoms. Laparoscopic treatment for patients with severe endometriosis of the bowel has becomes feasible and safe.
authors.affiliation: Department of Coloproctological Surgery, Juntendo University School of Medicine, Tokyo, Japan. kazusaka@med.juntendo.ac.jp
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Maeda
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Naofumi
authors.initials: N
authors.lastname: Takita
authors.forename: Sumito
authors.initials: S
authors.lastname: Suda
authors.forename: Tomoo
authors.initials: T
authors.lastname: Watanabe
authors.forename: Shuichi
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kamano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D012002:Rectal Diseases / Q000601:surgery*; D012810:Sigmoid Diseases / Q000601:surgery*