A Case of Recurrence of Severe Extensive Pelvic Endometriosis with Rectal Invasion

概要

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This case was a 28-year-old nulligravidous woman with pelvic endometriosis, who had previously undergone two conservative operations.Her chief complaints were massive vaginal bleeding and severe lower abdominal pain, which were presumably caused by extensive endometriosis with rectal invasion.Little could be done to improve the condition despite a 4000ml blood transfusion and Danazol therapy (800mg/day) for one month.It was concluded that the disease was impossible to treat conservatively since the lesions occupied the whole pelvis with severe adhesion of the uterus to adjacent organs, so we performed a hysterectomy with adnexectomy.Endometriotic foci filled the cul-de-sac and grew in the rectal lumen polypously, infiltrating through the rectal wall. Histopathology of the lesions showed benign endometriosis of dilated glands surrounded by decidua-like-stroma without atrophy
近畿産科婦人科学会の論文