RÉSUMÉ
UNLABELLED: 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 tissue were observed 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 SLIDE: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2975867306869166.
Sujet(s)
Maladies du caecum/complications , Endométriose/complications , Maladies de l'iléon/étiologie , Intussusception/étiologie , Douleur abdominale/étiologie , Douleur abdominale/thérapie , Analgésie , Marqueurs biologiques/analyse , Maladies du caecum/diagnostic , Maladies du caecum/métabolisme , Maladies du caecum/chirurgie , Endométriose/diagnostic , Endométriose/métabolisme , Endométriose/chirurgie , Femelle , Hospitalisation , Humains , Maladies de l'iléon/diagnostic , Maladies de l'iléon/métabolisme , Maladies de l'iléon/chirurgie , Immunohistochimie , Intussusception/diagnostic , Intussusception/métabolisme , Intussusception/chirurgie , Kératine-7/analyse , Néprilysine/analyse , Tomodensitométrie , Résultat thérapeutique , Jeune adulteRÉSUMÉ
OBJECTIVE: Our aim was to assess the feasibility and short-term results of cystocele repair by the placement of a synthetic subvesical mesh secured anteriorly through the obturator foramen. STUDY DESIGN: Between 1 November 2001 and 31 July 2002, 30 consecutive patients with a grade 2 (n = 18, 60%) or 3 (n =12, 40%) cystocele were prospectively included in the study. RESULTS: The obturator route was feasible in all cases. No intraoperative complications arose. After a mean follow-up of 6.7 months (range: 2-12), 90% (n = 27) of the patients were cystocele grade 0, 7% (n = 2) grade 1 and failure was observed in a young patient (3%) treated without hysterectomy. Two vaginal erosions (7%) were observed at six and nine months. For the 14 patients (47%) who had sexual relations after surgery, 2 (14%) complained of anterior dyspareunia. CONCLUSION: The obturator approach is a simple and sure technique for placing a polypropylene synthetic subvesical mesh. The long term stability and tolerance of the results must be confirmed.
