Theme |
Mesenchymal neoplasms of the colon and rectum : excluding lymphoproliferative disorders |
Title |
Intestinal endometriosis |
Author |
Jiro Watari |
Department of Endoscopy, Asahikawa Medical College Hospital |
Author |
Mikihiro Fujiya |
Division of Gastroenterology and Hematology / Oncology, Department of Medicine, Asahikawa Medical College |
Author |
Takahiro Ito |
Division of Gastroenterology and Hematology / Oncology, Department of Medicine, Asahikawa Medical College |
Author |
Ryu Sato |
Department of Endoscopy, Asahikawa Medical College Hospital |
Author |
Kentaro Moriichi |
Division of Gastroenterology and Hematology / Oncology, Department of Medicine, Asahikawa Medical College |
Author |
Kotaro Okamoto |
Division of Gastroenterology and Hematology / Oncology, Department of Medicine, Asahikawa Medical College |
Author |
Hiroki Tanabe |
Division of Gastroenterology and Hematology / Oncology, Department of Medicine, Asahikawa Medical College |
Author |
Atsuo Maemoto |
Division of Gastroenterology and Hematology / Oncology, Department of Medicine, Asahikawa Medical College |
Author |
Shin-ichi Izumi |
Division of Gastroenterology, Sapporo Orthopaedic Cadio-Vascular Hospital |
Author |
Masafumi Nomura |
Center for Gastroenterology, Teine Keijinkai Hospital |
Author |
Yutaka Kohgo |
Division of Gastroenterology and Hematology / Oncology, Department of Medicine, Asahikawa Medical College |
Author |
Yusuke Saitoh |
Digestive Disease Center, Asahikawa City Hospital |
[ Summary ] |
Clinical aspects, including radiographic and endoscopic findings of intestinal endometriosis are reviewed. Lesion were mainly located in the rectum and sigmoid colon, particularly on the anterior side. Barium enema examination is a useful modality for diagnosis of the lesions, which displayed a narrow segment with thickened folds, termed "transverse ridging", and extrinsic compression mimicking submucosal tumors, in the anterior wall of the rectum or sigmoid colon. Colonoscopic findings revealed a submucosal tumor like lesion with a reddish and granular mucosa, which was consistent with radiographic findings. However, it is often difficult to produce a correct image diagnosis of this disease or a histological diagnosis from the biopsy samples. As for differential diagnosis, it is important to differentiate metastatic colon cancer from type 4 colon cancer or inflammatory diseases, such as diverticulitis or mesenteric paniculitis. Although treatment for patients with intestinal endometriosis must be influenced by age and whether pregnancies are desired, hormonal therapy may be better as a first-line therapy. |