Is Endometriosis a Truly Benign Disorder? Report of a Case of Intestinal Endometriosis with Lymph Node Metastasis

Case Report

Austin J Reprod Med Infertil. 2015; 2(6): 1030.

Is Endometriosis a Truly Benign Disorder? Report of a Case of Intestinal Endometriosis with Lymph Node Metastasis

De Nardi Paola*

Department of Gastrointestinal Surgery, San Raffaele Scientific Institute, Milan, Italy

*Corresponding author: De Nardi Paola, Department of Gastrointestinal Surgery, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy

Received: August 24, 2015; Accepted: October 28, 2015; Published: October 30, 2015

Abstract

Endometriosis may affect the gastrointestinal tract in 3 to 37% of cases. However ileal involvement is rare accounting for 1-7% of all intestinal localizations. The case of a patient with an endometrial nodule on distal ileum wall, causing acute intestinal obstruction, who underwent right colectomy, is reported. The histology of the removed specimen also revealed the involvement of a regional lymph node. Several features of endometriosis raise questions about the benign nature of this disease.

Keywords: Deep infiltrating endometriosis; Intestinal endometriosis; lymph node endometriosis; Small bowel obstruction

Abbreviations

DIE: Deep Infiltrating Endometriosis

Case Presentation

A 43-year-old woman presented to our Emergency Department with cramping abdominal pain, nausea, vomiting and abdominal distension of 1 week duration. She complained milder but similar symptoms repeatedly over the past 6 months. She was nulliparous and her past medical history was marked by two spontaneous abortions. Laboratory tests showed elevated levels of white cells blood count (17.000/L), with no other abnormalities.

Abdominal plain X-ray (Figure 1) revealed markedly dilated ileal loops. Abdominal MRI (Figure 2) confirmed small bowel obstruction, but no clear cause could be detected. There was no evidence of enlarged lymph nodes.

Citation: De Nardi Paola. Is Endometriosis a Truly Benign Disorder? Report of a Case of Intestinal Endometriosis with Lymph Node Metastasis. Austin J Reprod Med Infertil. 2015; 2(6): 1030. ISSN:2471-0393