A CASE OF OBSTRUCTIVE ILEUS CAUSED BY ENDOMETORIOSIS IN THE ILEUM

A 45-year-old woman seen at the department because of a right lower quadrant abdominal pain at menstruation which started about 3 years before. Abdominal X-ray film revealed intestinal obstruction. Obstructive ileus following appendectomy was suspected and the patient was operated on. During surgery, adhesive ileus at the terminal ileum was detected. Ileocecal resection was performed. Pathological diagnosis was made with endometriosis in the ileum, Bowel endometriosis causing intestinal obstruction is rare. It presents difficulty in pre-and intra-operative diagnosis. In a review of the literature, 28 cases including this case have been reported in Japan. It was characteristic of this disease that seven cases (25%) had a previous history of endometriosis, and 14 cases (50%) developed symptoms at menstruations. Those symptoms included abdominal pain, consti-pation, melena, diarrhea, and vomitting. In this case, the patient also complained of abdominal pain and constipation at menstruations. Entertaining of these characteristics, careful attitude for history taking is very important to get the correct diagnosis.