Ileocolic intussusception due to a cecal endometriosis: Case report and review of literature

Abstract

Cecal endometriosis and ileocolic intussusception due to a cecal endometriosis is extremely rare. We report a case of a woman who presented an ileocecal intussusception due to a cecal endometriosis. The patient gave two months history of chronic periombilical pain requiring regular hospital admission and analgesia. The symptoms were not related to menses. A laparotomy was performed and revealed an ileocolic intussusception. The abdominal exploration did not find any endometriosis lesion. Ileocaecal resection was performed. Microscopic examination showed a cystic component, lined by a regular cylindric epithelium. Foci of endometrial tissu were oberved in the cecal subserosa and muscularis mucosal, with irregular endometrial glands lined by cylindric epithelium without atypia immunostained with CK7, and characteristic endometrial stroma immunostained with CD10. Cecal endometriosis and ileocolic intussusception due to a cecal endometriosis is extremely rare. Diagnose of etiology remains challenging due to the absence of clinical and radiological specific characteristics.Virtual slideThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2975867306869166

Consequences of delayed diagnosis of acute gastrointestinal intussusception, secondary to endometriosis

“…Emmanuel et al . published a case of ileocecal intussusception involving a 2‐month history of chronic periumbilical pain requiring regular hospital admission . The symptoms were not related to menses.…”

“…Frequent gastrointestinal locations of endometriosis are the rectum or the sigmoid (70–80%), and more rarely the appendix (3–10%), ileum (7–9%), and cecum (3–9%) . Ileocecocolic intussusception complicating cecal endometriotic lesion is a very rare complication of endometriosis . Because of this, clinical diagnosis is difficult and is often established only during surgery, because there are no specific symptoms.…”

“…1 Ileocecocolic intussusception complicating cecal endometriotic lesion is a very rare complication of endometriosis. 2 Because of this, clinical diagnosis is difficult and is often established only during surgery, because there are no specific symptoms.…”

Intussusception of terminal ileum into cecum associated with endometriosis

“…Intussusception – invagination or telescoping of a segment of bowel into an adjacent one, is typically a paediatric condition. Only 5% of total incidence has been described in adults, and 1% from these cases result in intestinal obstruction . In contrast, endometriosis occurs in up to 20% of women of childbearing age, defined by presence of extra‐uterine cavity endometriosis tissue .…”

“…Only 5% of total incidence has been described in adults, and 1% from these cases result in intestinal obstruction . In contrast, endometriosis occurs in up to 20% of women of childbearing age, defined by presence of extra‐uterine cavity endometriosis tissue . Endometriosis of ileum is rare and makes up about 3–18% of cases …”