Endometriose com ascite e pe ritonite encapsulante: uma revisão sistemática com descrição de um caso clínico

Thaís Vendramini [UNESP] Magalhães, Kathiane Lustosa Augusto, Livia Ponte Mota, Arthur Ribeiro da Costa, Rainardo Antônio Puster, Leonardo Robson Pinheiro Sobreira Bezerra
In: instacron:UFC · 2018 · W7120853031
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This systematic review of 42 women with endometriosis presenting with ascites and encapsulating peritonitis found that ascites was typically hemorrhagic and not predicted by CA-125 levels, supporting the condition as a differential diagnosis in reproductive-age women.

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This systematic review and case report examines the rare clinical presentation of endometriosis associated with ascites and encapsulating peritonitis. The authors analyze existing literature to describe the diagnostic challenges and management strategies for patients exhibiting these severe complications, illustrated through a detailed clinical case. They highlight that while uncommon, this condition requires high clinical suspicion due to its potential to mimic malignancy or other inflammatory processes. This paper is centrally about endometriosis — specifically focusing on rare extra-pelvic manifestations including ascites and encapsulating peritoneal sclerosis.

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Abstract

Endometriosis can have several different presentations, including overt ascites and peritonitis; increased awareness can improve diagnostic accuracy and patient outcomes. We aim to provide a systematic review and report a case of endometriosis with this unusual clinical presentation. The PubMed/MEDLINE database was systematically reviewed until October 2016. Women with histologically-proven endometriosis presenting with clinically signi fi cant ascites and/or frozen abdomen and/or encapsulating peritonitis were included; thosewithpotentiallyconfoundingconditionswere excluded.Oursearchyielded37articles describing 42 women, all of reproductive age. Ascites was mostly hemorrhagic, recurrent and not predicted by cancer antigen 125 (CA-125) levels. In turn, dysmenorrhea, dyspar- eunia and infertility were not consistently reported. The treatment choices and outcomes were different across the studies, and are described in detail. Endometriosis should be a differential diagnosis of massive hemorrhagic ascites in women of reproductive age
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endometriosisdysmenorrheainfertility

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