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DOI: 10.1055/s-2004-821028
Georg Thieme Verlag KG Stuttgart · New York
Komplikativer Verlauf bei Darmendometriose und Endometriose des Septum rectovaginale
Complicative Course in a Patient with Bowel Endometriosis and Endometriosis of the Cul-de-SacPublication History
Eingang Manuskript: 26. Februar 2004
Akzeptiert: 14. Mai 2004
Publication Date:
02 September 2004 (online)
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Zusammenfassung
Zu den schwersten Formen der extragenitalen Endometriose gehört die Endometriose des Septum rectovaginale mit Darmbeteiligung. Eine Endometriose des Darms verursacht für die betroffenen Patientinnen deutliche Beschwerden. Neben einer Dysmenorrhö und Dyspareunie treten intestinale Symptome wie zyklusabhängige Obstipation, Darmblutungen oder eine schmerzhafte Defäkation auf. Anhand eines komplikativen Verlaufs wird die Problematik der chirurgischen Sanierung besprochen. Die chirurgische Therapie der Endometriose des Septum rectovaginale und des Douglas sollte in spezialisierten Zentren mit der Möglichkeit einer tiefen anterioren Darmresektion unter Uteruserhaltung durchgeführt werden, um Komplikationen zu vermeiden.
Abstract
Endometriosis of the bowel and cul-de-sac is rare, but difficult to treat. It is the cause of severe trouble to affected patients. In addition to dysmenorrhoea and dyspareunia intestinal symptoms like menstruation-correlated obstipation, painful defaecation and rectal bleeding may occur. On the basis of a case report of a complicated course the problem of surgical treatment will be discussed. Operative treatment should be done in specialised centres with experience in bowel surgery, especially in deep anterior rectal resection, to avoid complications.
Schlüsselwörter
Darmendometriose - Endometriose des Septum rectovaginale - laparoskopisch-vaginale Operation - Komplikationen
Key words
Rectovaginal endometriosis - endometriosis of the cul-de-sac - combined laparoscopic-vaginal treatment - complications
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Prof. Dr. Achim Schneider MPH, Professor und Direktor
Abteilung Frauenheilkunde der Klinik für Frauenheilkunde und Geburtshilfe der Friedrich-Schiller-Universität Jena
Bachstraße 18
07740 Jena
Email: achim.schneider@med.uni-jena.de