ESTENOSIS RECTAL BENIGNA COMO EXPRESIÓN DE ENDOMETRIOSIS. A PROPÓSITO DE UN CASO

La Endometriosis consiste en la aparicion y crecimiento de tejido endometrial fuera del utero. La causa es desconocida, Tambien sugiere que puede ser hereditaria. Otros investigadores han senalado la participacion del sistema inmunologico, y endocrino. En nuestro caso se evalua a paciente femenina de 40 anos de edad, quien acude por presentar proctalgia, estrenimiento, dolor abdominal, y perdida de peso, niega antecedentes patologicos, embarazos y/o abortos; al examen funcional dismenorrea, ciclos menstruales regulares; examen fisico sin alteraciones, abdomen sin megalias, al tacto rectal impresiona estenosis en recto bajo, por lo que se realiza estudio endoscopico inferior, y se constata estenosis en recto alto, de bordes regulares, concentrica, de aspecto benigno, de aproximadamente 1,5 cm de diametro. Se practica ultrasonido abdominal, pelvico, transvaginal, y tomografia de abdomen y pelvis, cuyo reporte coincide en diagnostico de aglomeracion de asas intestinales entre utero y recto, en relacion a probable plastron. En relacion a la estenosis se inicia esquema de dilataciones con balon hidroneumatico, no presenta mejoria, decidiendose resolucion quirurgica. La biopsia de la pieza anatomica reporta endometriosis.(AU) Endometriosis consists on the appearance and growth of endometrial tissue outside the uterus such as, in the ovaries, uterine ligaments, urinary bladder or the intestine. Endometriosis cause is unknown, nevertheless there are theories affirming that during menstruation, part of endometrial tissue implants itself and grows inside of the cavity. It is also suggested that it can be hereditary. Other researchers have pointed out immunologic and endocrine system involvement. On this center´s gastroenterology appointment is studied a 40 year-old female patient, who assists for presenting proctalgia and prolonged constipation, a loss of weight is associated. Patient denies pathologic background, as well as pregnancies and/or abortions to the physical examination. Patient is on stable clinical conditions, abdomen without any masses. Stenosis on low rectum is evidenced on rectum touch, and a regular-concentric benign stenosis is confirmed, with approximately 1,5cm of diameter. A transvaginal-abdominal-pelvic ultrasound examination, as well as an axial-abdominal and pelvic tomography is realized. Afterwards, dilations`scheme with a pneumatic ball was realized, nevertheless patient did not get better, in which case a surgical resolution, which an anatomic piece reports endometriosis, was decided.(AU)