気胸を合併した回盲部子宮内膜症の1例

Ileocecal Endometriosis with Pneumothorax, Report of a Case

要旨　患者は41歳，女性．腹痛と嘔吐を主訴に来院．腹部X線より，腸閉塞と診断，イレウスチューブの挿入にて腸閉塞は速やかに解除された．注腸，小腸X線検査にて回腸末端の高度な狭窄，近接する回腸の伸展不良，屈曲と盲腸部の平滑な陰影欠損を認めた．内視鏡検査では回盲弁を頂点とする粘膜下腫瘍様隆起を認めた．生理の周期と一致する臨床所見と合わせ回盲部の腸管子宮内膜症と診断し，回盲部切除術を施行した．切除標本の病理組織的所見で腸管子宮内膜症を確認した．術後生理期間中に右気胸を発症し，月経随伴性気胸も合併したと考えられた．

　A 41-year-old female was admitted because of ileus. The ileus was resolved promptly by the use of an ileus tube. Barium enema examination showed an extrinsic filling defect at the cecum. The radiography of the small intestine showed severe stenosis of the terminal ileum and adhesion of the ileum. Colonoscopy showed a submucosal tumor-like lesion with the top of the ileocecal valve at the cecum. Ileocecal resection was performed under a tentative diagnosis of intestinal endometriosis. Histopathological examination showed intestinal endometriosis in the ileocecal region. On the 8th day after the operation and during the period of menstruation, the patient presented rt-pneumothorax. Catamenial pneumothorax was suspected.

　It is very rarely that intestinal endometriosis is complicated with catamenial pneumothorax.