Pathophysiology of Cyclic Hemorrhagic Ascites and Endometriosis

Anastasia Ussia, Ussia A, Betsas G, George Betsas, Roberta Corona, Corona R, Carlo De Cicco, Carlo De Cicco Nardone, Philippe R Koninckx, Koninckx PR
Journal of Minimally Invasive Gynecology · 2008 · vol. 15(6) , pp. 677–681 · doi:10.1016/j.jmig.2008.08.012 · PMID:18971129 · W2022051722
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This paper describes the pathophysiology of cyclic hemorrhagic ascites and endometriosis, a condition characterized by recurrent fluid accumulation in the abdomen and the presence of endometrial tissue outside the uterus.

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Abstract

Massive hemorrhagic ascites (4470 mL, range 1-10 L) in women with endometriosis is a rare condition occurring predominantly in black women. Of the 43 case reports published, 42 are compatible with the hypothesis that the hemorrhagic ascites is predominantly a consequence of excessive ovarian transudation similar to a Meigs syndrome. Indeed, bilateral ovariectomy cures the condition without recurrences, whereas after unilateral ovariectomy or cystectomy recurrence rate is more than 50%; during ovarian suppression by luteinizing hormone-releasing hormone agonist ascites disappears, but reappears after treatment. Superficial pelvic endometriosis also contributes to the ascites because after superficial endometriosis destruction the recurrence rate is only 4 in 14. Based on these data, it is suggested, to scrutinize the ovaries for tumors given the analogy with Meigs syndrome. In women desiring fertility, conservative treatment with destruction of endometriosis only can be attempted given the cure rate of some 20%. It is unknown what the effect of ovulation induction would be.

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Condition tags

endometriosis

MeSH descriptors

Ascites Endometriosis Hemorrhage Menstrual Cycle Adult Ascites Ascites Endometriosis Endometriosis Female Hemorrhage Hemorrhage Hemothorax Hemothorax Humans Inflammation Inflammation Menstrual Cycle Middle Aged Young Adult

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (60)

Cited by (30)

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