Endometriosis bowel

The intestine is usually affected by endometriosis again, in the dissemination process of the ovaries, POSADSKOGO focus or neck of the uterus on the wall of the intestine. Rarely observed the transition of endometriosis in the gut of scars and the navel. The primary lesion of the intestine (in the absence of disease in other organs, from which it could spread to the rectum) is rare and occurs as a result emetogenna adding elements of the endometrium in the intestine wall.
Filed R. Tagart (1959), 1-2 % of all menstruating women suffer from endometriosis of rectum and sigmoid colon. N. Spjut, D. Perkins (1959) indicate that 18-25 % of women with endometriosis, pelvic affected and intestines. By G. Kratzer E. Salvati (1955), in 34 % of patients with endometriosis was amazed at the large intestine.
Some interest information C. Green et al. (1957), according to which the sigmoid colon endometriosis was found in 6 % of women operated on for suspected carcinoma of the colon.
In addition, the clinical significance of endometriosis is that it can cause obstruction and spontaneous perforation of the bowel wall. N. ROher, K. GrOzinger (1973) on the basis of studying of clinic, diagnostics and treatment of endometriosis colon came to the conclusion that it is necessary to consider endometriosis in the differential diagnosis of intestinal obstruction. B. N. Baskakov, et al. (1978) drew attention to the bowel endometriosis as the reason of development of acute abdomen.
From all sections of the intestine endometriosis, most (70 - 80 %) strikes a direct and sigmoid colon, then a skinny, at least - blind and even more rarely - vermiform process.
Unlike carcinoma endometriosis affects the intestinal wall from the side of the serous membranes or the outer part of the muscular layer, when the process involved retroperitoneal Department of the colon. Endometriosis cancer can be localized in one area (in the ingrowth of endometrioid cysts, POSADSKOGO site or from the isthmus of the uterus) or in several places. The latter occurs if the perforation endometrioid cysts or retrograde throwing menstrual blood on the fallopian tubes.
On the surface of endometrial cancer include overlook small spots and stripes of blue. They gradually turn into knots and plaques, around which there are radially located scars. Further ingrowth of endometriosis in thickness ulcers can occur in the radial direction or begins coverage ulcer along the circle. Both types of growth accompanied by thickening of the wall of the intestine, education site or tumor grows up 3-5-8 cm in diameter and narrowing its clearance. In cases of germination of all thickness of an ulcer on her mucosa can be formed polypoid expansion. The nodes of endometriosis in the intestine does not have a connective tissue capsule and gradually, first in infiltrated and then in an unmodified portion of the bowel wall. The main part of the nodes or diffuse enlargement, when there is a circular coverage intestine consists of scar, part galinadiamond, connective tissue, small cell infiltration and hyperplastic muscle fibers. In this fabric has alopecia inclusion (cell), filled with brown or hemorrhagic fluid. Histological examination of these inclusions are glandular endometrioidalny epithelium (tubular and branching tubules) and citigrou stroma. As in other institutions, in the wall of the intestine ratio of glandular elements and stroma can vary. The closer location of endometrioid heterotopy to the lining of the intestine, the more presents glandular elements and less stroma. Sometimes there is only the glandular tissue and at least - one of the stroma. Both of these extreme forms can cause difficulties in interpretation of the results of histological examination byobserving material, if the morphologist not be familiar with the clinic of the disease and will not consider features of endometriosis. The different proportions of glandular elements and stroma of heterotopia, apparently, is not only in the deciphering of histological preparations, but also in the fate of endometriosis. For example, sarcomatosis the transformation of endometriosis in the bowel wall is more likely to occur in cases of prevalence of stromal elements. So you can interpret the message P. Nylander (1938), De la Para about the development of sarcoma of endometriosis of rectum and sigmoid colon.

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