Ulus Travma Acil Cerrahi Derg. 2020; 26(1): 148-151 | DOI: 10.5505/tjtes.2018.62705

Nadir görülen bir akut mekanik intestinal obstrüksiyon olgusu: Kolonik endometriozis

Mehmet Zeki Buldanlý¹, Ýbrahim Ali Özemir², Oktay Yener², Yasemin Dölek^3
1Çankýrý Devlet Hastanesi, Genel Cerrahi Kliniði, Çankýrý
²Ýstanbul Medeniyet Üniversitesi, Göztepe Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Ýstanbul
³Çankýrý Devlet Hastanesi, Týbbi Patoloji Kliniði, Çankýrý

Endometriozis, üreme çaðý kadýnlarda görülen, endometrium dokusunun uterus dýþýnda yer almasý ile kendini gösteren bir hastalýktýr. Kolonik endometriozis menstrüal siklusla iliþkili pelvik aðrý, disparoni, tenesmus ve aðrýlý dýþkýlama þikayetleri ile ortaya çýkabildiði gibi, nadiren akut mekanik intestinal obstrüksiyona (AMÝO) da yol açabilmektedir. Literatürde %3–37 oranýnda gastrointestinal yerleþim bildirilmiþ olup bu olgularýn da %7–23’ünde AMIO kliniði bildirilmiþtir. Literatürde kolon malignitesini taklit eden sigmoid endometriozise baðlý az sayýda mekanik obstrüksiyon olgusu bulunmaktadýr. Biz de kolonik endometriozise ikincil olarak geliþen AMÝO saptanan 40 yaþýndaki kadýn hastayý literatür eþliðinde sunmayý amaçladýk. Hartmann prosedürü uygulanan ve cerrahi tam iyileþme ile taburcu edilen hastada patolojik incelemede endometriozis tespit edildi. Ameliyat sonrasý 6. ayda kolostomi kapatýlmasý ve kendi isteðiyle bilateral ooferektomi operasyonu uygulanan hastanýn takipleri devam etmektedir. Endometriozis tüm organlarý tutabilen jinekolojik bir hastalýk olup gastrointestinal yerleþimi AMÝO etiyolojisinde özellikle reprodüktif dönemdeki kadýn hastalarda akýlda tutulmalý ve iliþkili semptomlar sorgulanmalýdýr.

Anahtar Kelimeler: Akut mekanik intestinal obstrüksiyon, endometriozis; ileus.

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A rare case of acute mechanical intestinal obstruction: Colonic endometriosis

Mehmet Zeki Buldanlý¹, Ýbrahim Ali Özemir², Oktay Yener², Yasemin Dölek^3
1Department of General Surgery, Çankýrý State Hospital, Çankýrý-Turkey
²Department of General Surgery, Ýstanbul Medeniyet University, Göztepe Training and Research Hospital, Ýstanbul-Turkey
³Department of Medical Pathology, Çankýrý State Hospital, Çankýrý-Turkey

Endometriosis is a disease seen in women at reproductive age, characterized by extrauterine localization of endometrial tissue. Colonic endometriosis rarely causes acute mechanical intestinal obstruction (AMIO). It may also be presented with pelvic pain, dyspareunia, tenesmus, painful defecation related to the menstrual cycle. In the literature, 3-37% of the gastrointestinal location was reported and AMIO was observed in 7-23% of these cases. There are only few cases of mechanical obstruction related to sigmoid endometriosis mimicking colon malignancy. In this study, we aim to report a case of a 40-year-old patient with AMIO developed secondary to colonic endometriosis in light of the literature. The patient was discharged with full surgical recovery after the Hartmann procedure was performed, and the pathological diagnosis was reached as endometriosis. At the post-operative sixth-month colostomy, closure and bilateral oophorectomy were performed with the patient’s will. The patient was discharged with surgical recovery and is still being regularly followed up. Endometriosis is a gynecological disease that may occur in all organ systems even though the most common location is the overs. Gastrointestinal located endometriosis should, therefore, be kept in mind in the etiology of AMIO in women at reproductive age and the related symptoms should be questioned in differential diagnosis.

Keywords: Acute mechanical intestinal obstruction, endometriosis; ileus.

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