Эндометриоз кишечника: современные аспекты патогенеза, клинической картины и дифференциальной диагностики (обзор зарубежной литературы)

Эндометриоз – патологический процесс, при котором определяется наличие ткани, по морфологическим и функциональным свойствам подобной эндометрию, вне полости матки. Эндометриозом страдают 10% (190 млн) женщин репродуктивного возраста во всем мире. Эндометриоз кишечника представляет собой патологическое состояние, при котором происходит инфильтрация кишечника эктопической эндометриальной тканью. Его распространенность составляет 3–37% среди всех женщин, страдающих эндометриозом. Проведен анализ научных публикаций, посвященных различным аспектам изучения эндометриоза кишечника, в базе PubMed, опубликованных до 15.01.2026. Патогенез эндометриоза является многофакторным и включает гормональные, иммунные и микробиомные аспекты. В последние годы широко обсуждается роль микробиоты кишечника и иммунной дисрегуляции в развитии эндометриоза. Новым направлением является изучение роли патологии пародонта. В клинической картине эндометриоза наряду с типичными гинекологическими проявлениями часто встречаются гастроинтестинальные симптомы. Абдоминальная боль и нарушения стула у женщин репродуктивного возраста предполагают широкий спектр дифференциальной диагностики, включая синдром раздраженного кишечника, воспалительные заболевания кишечника и ряд других заболеваний/состояний. Эндометриоз кишечника может стать диагностической проблемой для терапевта. Трудности дифференциальной диагностики обусловлены сходством клинических проявлений данного заболевания с синдромом раздраженного кишечника, воспалительными заболеваниями кишечника, целиакией, опухолевыми заболеваниями кишечника. Наличие гастроинтестинальных симптомов при генитальном эндометриозе и эндометриозе кишечника может затруднять их диагностику в течение длительного времени. При проведении дифференциальной диагностики заболеваний кишечника необходимо учитывать и возможное наличие эндометриоза кишечника.

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