Twisted Troubles: A Rare Case of Intestinal Obstruction Due to Endometriosis and a Review of the Literature
Abstract
:1. Introduction
2. Materials and Methods
3. Case Report
3.1. Timeline
3.2. Diagnostic Assessment
3.3. Imagistic Findings
3.4. Intraoperative Findings
3.5. Surgical Intervention
3.6. Histopathological Findings
3.7. Postoperative Course
3.8. Follow-Up Surgery
4. Discussion and Literature Review
4.1. Extragenital Endometriosis
4.2. DIE of the Small Bowel, Large Bowel, and Appendix
4.3. Ultrasound Findings of Intestinal Volvulus Due to Extragenital Endometriosis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Author | Year | Patient Details | Symptoms | Diagnostic Methods | Treatment | Outcome |
---|---|---|---|---|---|---|
Kondo et al. [30] | 2020 | Case series of 5 patients, aged 49, 48, 50, 37 and 43 | Abdominal pain, bloating, bowel obstruction | Various tests: fecal occult blood test, colonoscopy, barium enema, CT scan, MRI | Laparoscopic sigmoidectomy, low anterior laparoscopic rectum resection, partial small bowel resection, high anterior laparoscopic colonic resection, and laparoscopic sigmoidectomy with side-to-side anastomosis | Good recovery for all 5 patients |
Zepeda et al. [31] | 2021 | Case report, patient age 41 | Abdominal pain, vomiting, constipation, dysuria and menorrhagia | CT scan, laparoscopy | Exploratory laparotomy at first, a large portion of distal ileum was resected along with the appendix | Complete recovery, symptom-free |
Leborne et al. [32] | 2022 | Retrospective study, 165 women with DIE, median age 34 | Dysmenorrhea, heavy menstrual bleeding, chronic pelvic pain, bowel obstruction | MRI, colonoscopy, histopathology | Hysterectomy was conducted in 22% of the cases, bowel segment or discoid resection surgery for almost 27%, and 77%—bowel shaving. 13.63% underwent a temporary protective ileostomy after their resection anastomosis procedure; 36.81% underwent ureterolysis, and 3.03% undertook vesical resection. | 34 women had recurrence of the pain after a median duration of 12 months post-surgery; 23 women needed a second surgery after a median period of 22 months. According to the Clavien Dindo classification, 3 patients had grade IIIB complications and one grade IVA (intravenous anesthesia). |
Ragab et al. [33] | 2023 | Case report, patient age 40 | Abdominal pain, diarrhoea, vomiting, unable to tolerate oral intake, urinary tract infection. | Abdominal X-ray, CT scan, colonoscopic stenting was attempted, but the guide wire was unable to pass through the lumen, exploratory laparotomy. | Appendectomy stump, and extended left hemicolectomy was conducted due to compromised blood supply of the marginal arteries | Full recovery with no complications, oral food intake from the 1st day post-surgery, discharged on the 8th day post-op. |
Thirumurthy et al. [34] | 2024 | Case report, patient age 35 | 2 years of abdominal pain, nausea and vomiting, no association with menstrual cycle | CT scan | Laparoscopic ileum resection and a limited resection of the ascending colon | Symptom-free at follow-up |
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Iordache, I.E.; Alexandrescu, L.; Nicoara, A.D.; Popescu, R.; Leopa, N.; Baltatescu, G.; Nelson Twakor, A.; Tofolean, I.T.; Steriu, L. Twisted Troubles: A Rare Case of Intestinal Obstruction Due to Endometriosis and a Review of the Literature. Clin. Pract. 2024, 14, 2027-2043. https://doi.org/10.3390/clinpract14050160
Iordache IE, Alexandrescu L, Nicoara AD, Popescu R, Leopa N, Baltatescu G, Nelson Twakor A, Tofolean IT, Steriu L. Twisted Troubles: A Rare Case of Intestinal Obstruction Due to Endometriosis and a Review of the Literature. Clinics and Practice. 2024; 14(5):2027-2043. https://doi.org/10.3390/clinpract14050160
Chicago/Turabian StyleIordache, Ionut Eduard, Luana Alexandrescu, Alina Doina Nicoara, Razvan Popescu, Nicoleta Leopa, Gabriela Baltatescu, Andreea Nelson Twakor, Ionut Tiberiu Tofolean, and Liliana Steriu. 2024. "Twisted Troubles: A Rare Case of Intestinal Obstruction Due to Endometriosis and a Review of the Literature" Clinics and Practice 14, no. 5: 2027-2043. https://doi.org/10.3390/clinpract14050160