Endometriosis presenting as pleural effusion and haemoperitoneum: case report and a review of the literature

A case of endometriosis presenting as haemorrhagic pleural effusion and ascites in a 40 year old multiparous woman is described. Her main clinical features were left groin swelling 12 years prior to this presentation which was confirmed at histology (after excision) to be endometriosis; secondary infertility, peri-umbilical nodule with cyclic pain especially during the menstrual flow; secondary dysmenorrhoea, dyspareunia, irregular menses, inter-menstrual bleeding, dyspnoea and abdominal swelling. Investigations revealed pleural effusion on chest X-ray and a complex pelvic-abdominal mass with ascites on ultrasonography. She was managed with danazol, thoracotomy and, eventually, laparotomy. Subtotal hysterectomy with bilateral salpingoophorectomy was performed and histological examination of the tissues confirmed endometriosis and adenomyosis. Keywords: endometriosis, pleural effusion, ascites Tropical Journal of Obstetrics and Gynaecology Vol. 23(1) 2006: 77-79