ホルモン療法により経過観察した腸管子宮内膜症の2例

Sigmoid Colon Endometriosis Treated with LH-RH Analogue, Report of Two Cases

要旨　LH-RHアナログを用いたホルモン療法を施行し，経過観察を行いえたS状結腸子宮内膜症の2例を経験した．2例ともに子宮内膜組織のS状結腸粘膜面への露出はみられず，画像所見上は漿膜側からの圧排，浸潤所見であった，また生理周期に一致した下血を認めなかった．ホルモン療法を施行した結果，2例ともにS状結腸漿膜筋層側を主座とする子宮内膜組織が萎縮したと考えられる画像所見の改善を認めた．ホルモン療法単独では再発率も高く，今後の厳重な経過観察が必要と考えられた．

　We encountered two cases of sigmoid colon endometriosis who received hormonal treatment with LH-RH analogue and were followed up. In both cases, colonoscopic and radiologic examination revealed an extrinsic compression and a mucosal crenulation. The mucosal pattern remained intact. Hematochezia during the period of menstrual flow was not observed. After hormonal therapy, colonoscopic and radiologic examination showed an improvement of the findings which was thought to result from resolution of endometrial involvement in the bowel wall. However, in patients with symptomatic enteric endometriosis, high rates of recurrence after hormonal treatment have been reported. Following the completion of the therapy, they should be kept under close observation.