Komplikativer Verlauf bei Darmendometriose und Endometriose des Septum rectovaginale

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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