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- Title
Crohn's disease mimicking as bowel endometriosis. Are the symptoms reduced by nafarelin acetate?
- Authors
Nakao, Atsunori; Iwagaki, Hiromi; Kanagawa, Taiichiro; Jikuhara, Atsushi; Matsubara, Nagahide; Takakura, Norihisa; Isozaki, Hiroshi; Tanaka, Noriaki; Nakao, A; Iwagaki, H; Kanagawa, T; Jikuhara, A; Matsubara, N; Takakura, N; Isozaki, H; Tanaka, N
- Abstract
We report a 27-year-old female with Crohn's disease clinically misdiagnosed with intestinal endometriosis. Her complaints were abdominal pain and fullness, which occurred monthly during her menstrual period. Although we had no histopathological evidence, we diagnosed her as bowel endometriosis on the basis of her clinical course. Since nafarelin acetate therapy started, the symptoms due to mechanical subileus have improved. The transverse colon, a 70 cm segment of the ileum, including the terminal ileum, were resected because of repeated symptoms of bowel obstruction despite prolonged nafarelin therapy. Histopathological findings of the resected specimen revealed Crohn's disease without endometrial tissue. In our patient, an increased cortisol and ACTH secretion, a side effect of nafarelin, was noted during the therapy. This case showed that nafarelin therapy could increase serum concentration of ACTH and cortisol, which was considered to suppress the pathology of Crohn's disease by its anti-inflammatory action. We emphasize that intestinal examination must be performed with Crohn's disease in mind, even if nafarelin acetate is effective.
- Subjects
CROHN'S disease; ENDOMETRIOSIS; ENDOMETRIUM; FEMALE reproductive organ diseases; PELVIC diseases; OBSTETRICS; GYNECOLOGY
- Publication
Archives of Gynecology & Obstetrics, 2000, Vol 263, Issue 3, p131
- ISSN
0932-0067
- Publication type
journal article
- DOI
10.1007/s004040050011