PDF(Pubmed)
Abstract：
The prevalence of intestinal endometriosis has been estimated to be between 3% and 37% of all endometriosis cases. Cases of intestinal occlusion due to endometriosis foci on the small bowel and on the large bowel are even rarer, with a reported prevalence of 0.1-0.7%. The aim of this literature review was to summarize the available published evidence on the diagnosis, characteristics, and management of intestinal occlusion due to endometriosis. The search on PubMed retrieved 295 records, of which 158 were rejected following a review of the title and abstract. After reviewing the full text, 97 studies met the Population, Intervention, Comparator, Outcomes, and Study (PICOS) criteria and were included in the analysis. The total number of patients with bowel occlusion due to endometriosis included in the studies was 107. The occlusive endometrial foci were localized on the ileum in 38.3% of the cases, on the rectosigmoid in 34.5% of the cases, at the ileocecal junction and the appendix in 14.9% of the cases, and at the rectum in 10.2% of the cases. Only one case reported large bowel obstruction by endometriosis of the hepatic flexure of the colon extending to the transverse colon (0.9%), and in one case the obstruction was caused by an omental giant endometrioid cyst compressing the intestines. We identified six cases of postmenopausal females with acute bowel obstruction due to endometriosis. Malignant degeneration of endometriosis was also identified as a cause of intestinal occlusion. The mechanisms of obstruction include the presence of a mass in the lumen of the intestine or in the wall of the intestine, extrinsic compression, adhesions, or intussusception.
摘要：
据估计，肠道子宫内膜异位症的患病率在所有子宫内膜异位症病例的3％至37％之间。由于子宫内膜异位症病灶在小肠和大肠引起的肠闭塞的病例甚至更罕见，报告的患病率为0.1-0.7%。这篇文献综述的目的是总结现有的诊断证据，特点,以及子宫内膜异位症引起的肠闭塞的管理。PubMed上的搜索检索到295条记录，其中158人在审查标题和摘要后被拒绝。在查看全文之后，97项研究符合人口，干预,比较器,结果，和研究（PICOS）标准，并纳入分析。纳入研究的子宫内膜异位症导致肠阻塞的患者总数为107例。在38.3％的病例中，闭塞性子宫内膜灶位于回肠上，34.5%的病例在直肠乙状结肠上，14.9%的病例在回盲部和阑尾，10.2%的病例出现在直肠。只有1例报告结肠肝曲延伸至横结肠的子宫内膜异位症引起的大肠梗阻（0.9％），在一个案例中，阻塞是由巨大的网膜子宫内膜样囊肿压迫肠道引起的。我们确定了6例绝经后女性因子宫内膜异位症引起的急性肠梗阻。子宫内膜异位症的恶性变性也被确定为肠道闭塞的原因。阻塞的机制包括肠腔或肠壁中存在肿块，外在压缩，粘连,或者肠套叠.
