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

Olufunmilayo Lesi, MO Kehinde
In: Nigerian Medical Practitioner · 2004 · vol. 44(1) · doi:10.4314/nmp.v44i1.28677 · W2055791887
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This case report describes massive hemorrhagic ascites and pleural effusion due to endometriosis, highlighting percutaneous peritoneal biopsy for diagnosis and hormonal therapy for remission.

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This case report and literature review describes a patient presenting with massive haemorrhagic ascites and right-sided pleural effusion, conditions rarely associated with endometriosis. Diagnostic percutaneous peritoneal biopsy confirmed peritoneal endometriosis, leading to treatment with Danazole that resulted in remission of disease activity. The authors highlight this as one of the few potentially curable causes of haemorrhagic ascites and emphasize the diagnostic utility of peritoneal biopsy for obscure bloody fluid collections. This paper is centrally about endometriosis — specifically an unusual presentation involving haemorrhagic ascites and pleural effusion.

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Abstract

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
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OA Lesi Gastroenterology Unit, Department of Medicine, College of Medicine, University of Lagos, PMB 12003, Lagos, Nigeria MO Kehinde Gastroenterology Unit, Department of Medicine, College of Medicine, University of Lagos, PMB 12003, Lagos, Nigeria Abstract 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

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endometriosis

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