腸管子宮内膜症の画像診断―組織学的に証明された13症例の検討

Diagnostic Imaging for Intestinal Endometriosis

要旨　過去23年間に経験した腸管子宮内膜症13例について述べた．13例中10例(76.9％)で直腸からS状結腸に認められ，最も頻度が高かった．ほかには虫垂に2例，小腸に1例で認められた．5症例で注腸検査を施行され，腸管子宮内膜症の特徴的な所見として，①直腸RsからS状結腸の前壁主体とした偏側性の陰影欠損像，②腸管の長軸方向に垂直な幅4～5mmのひだ(transverse ridging)，③cobblestone様顆粒状変化を認めた．腸管子宮内膜症の診断には臨床経過，症状から診断されることが多いが，注腸X線検査，大腸内視鏡検査の所見も特徴的な所見を呈することがある．

　Radiographic and endoscopic findings were assessed in thirteen female patients with intestinal endometriosis. Rectal and sigmoid lesions were observed in ten of the patients, appendiceal lesions in two patients, and a small intestinal lesion in one patient. Barium enema studies revealed the following: mass-defect-like submucosal tumor in the anterior side from the sigmoid colon to the rectum, many transverse ridging lesions and, granular change with cobblestone appearance. The endoscopic findings, converging folds and granular change, were consistent with the radiographic ones.

　The findings were characteristic of patients with intestinal endometriosis. Radiographic and endoscopic examination seems to be useful for the diagnosis of intestinal endometriosis.