[Intestinal endometriosis causing subacute ileus. Experience in three cases]

We present three rare cases of intestinal endometriosis. The patients were treated at the Endometriosis Clinic of the 1st Dept. of Obstetrics and Gynecology of the Semmelweis University, Budapest. Their main symptom besides the classic symptoms of endometriosis (dysmenorrhea, dyspareunia, pelvic pain) was the catamenial haematochesia--a subacute obstruction which became more intensive in the perimenstrum and needed medical treatment but no surgical intervention. Because of the recurrent complaints, after detailed check-up and biopsy of the obstructing intestinal endometriosis, anterior resection of the rectum was performed with endocoagulation or extirpation of other endometriosis implants of the pelvis. Depending on the severity of pre or postoperative complaints patients underwent a GnRH-analogue therapy for six months. In one patient because of the patient's age, and extensive retrocervical-deep endometriosis causing serious dyspareunia--the resection was performed with additional hysterectomy and adnexectomy (TAH). Recently the patient is on monophasic hormone replacement therapy. In the two other patients after a second-look laparoscopy with testing the lumen of the tubes treatment was started for the induction--because of infertility. We give an overview of the frequency, incidence and possible pathomechanism of pelvic endometriosis. We describe the modern diagnostic and therapeutic tools of pelvic endometriosis.