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language
eng
Author
KAWASHIMA, Kosaku Department of Internal Medicine II, Shimane University Faculty of Medicine
Sumi, Shohei Department of Internal Medicine II, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
Sonoyama, Hiroyuki
ISHIHARA, Shunji Department of Internal Medicine II, Shimane University Faculty of Medicine
Description
We report a case of sigmoid endometriosis diagnosed preoperatively based on endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) findings. A 42-year-old female came to us with left lower abdominal pain and bloating that had started 3 months prior. CT and MRI results showed wall thickening of the sigmoid colon. A colonoscopy procedure could not be completed because passage through the sigmoid colon was blocked due to severe stenosis, while mucosal biopsy samples obtained during that procedure could not confirm a diagnosis. EUS-FNA was then performed and specimens were obtained from the muscular layer with stenosis, which revealed a thickened hypoechoic lesion. Histological findings obtained by use of EUS-FNA demonstrated a large amount of fibrosis in endometrial glands and a diagnosis of sigmoid endometriosis was confirmed by additional immunostaining. Thus, a laparoscopic sigmoidectomy was performed, with sigmoid endometriosis finally diagnosed. Confirmation of a diagnosis of intestinal endometriosis based on histological findings of mucosal biopsy specimens obtained by colonoscopy is difficult, because endometrial implants are primarily located in the serosal and/or muscular layer. When safe aspiration is possible, we consider that EUS-FNA can be an effective method for preoperative diagnosis of intestinal endometriosis, which may contribute to avoidance of unnecessary or excessive surgery.
Subject
Sigmoid endometriosis
EUS-FNA
Preoperative diagnosis
Journal Title
Clinical Journal of Gastroenterology
Volume
13
Start Page
158
End Page
163
ISSN
1865-7257
ISSN(Online)
1865-7265
Published Date
2019-09-23
DOI
Publisher
Springer Nature
NII Type
Journal Article
Format
PDF
Relation
Text Version
著者版
Gyoseki ID
e38112
OAI-PMH Set
Faculty of Medicine