How to treat endometriosis?
A 46-year old female presented with an acute small bowel obstruction. She had a paucity of background surgical history, having only had a laparoscopic cholecystectomy. Her CT demonstrated small bowel obstruction with a transition point in the distal ileum. Given the site of obstruction was remote from previous surgery, a high index of suspicion was maintained and early laparoscopy performed the same day. Operative findings were consistent with an endometrial stricture of the distal ileum and a formal resection was performed. How to treat endometriosis?
@kukum Endometriosis is defined as the presence of endometrial tissue in an ectopic location outside of the uterus, and can be prevalent in around 10–15% of all menstruating women. The most common site for endometriosis are the ovaries and uterosacral ligaments. Although the aetiology is unknown, the Sampson’s retrograde menstruation theory of endometrial tissue reflux through the fallopian tubes and intra-abdominal visceral implantation and growth, is the most widely accepted. This oestrogen-dependent disorder can result in significant morbidity with chronic pelvic pain, multiple operations and infertility. Those affected are also at a higher than population-risk of developing ovarian cancer and potentially breast and other cancers. Endometriosis usually becomes more apparent during the patient’s reproductive years.