Massive Haemorrhagic Ascites and Pleural effusion: An Unusual Presentation of Endometriosis. A Case report and Literature Review

The association between endometriosis and haemorrhagic (bloody) ascites is rare.Since its first description by Brews in 1954,only a few sporadic cases have been reported in the literature. We report a case of massive haemorrhagic ascites associated with right-sided pleural effussion.Therapeutic paracentesis of eight litres of brownish haemorrhagic fluid and transfusion of blood and colloids led to short-term symptomatic relief.A histological diagnosis of peritoneal endometriosis was made by tissue obtained at percutaneous peritoneal biopsy.Conservative hormonal treatment using Danazole therapy led to a remission of disease activity. This case illustrates the uncommon presentation of a relatively common disorder,and represents one of the few potentially curable causes of haemorrhagic ascites .It also serves to emphasize the utility of a percutaneous peritoneal biopsy in the investi gation of exudative and bloody ascites of obscure origin. Key Words: Haemorrhagic ascites,pleural effusion,endometriosis,peritoneal biopsy Nigerian Medical Practitioner Vol.44(1) 2003: 22-24