Dienogest Was Effective in Treating Hemorrhagic Ascites Caused by Endometriosis: A Case Report
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This case report details the successful treatment of hemorrhagic ascites stemming from endometriosis using dienogest.
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Abstract
Hemorrhagic ascites caused by endometriosis is extremely rare, and its treatment is under discussion. We report a case of recurrent endometriosis-related ascites treated with dienogest (DNG). A 35-year-old nulliparous Japanese woman with a history of infertility presented with worsening dysmenorrhea and abdominal distention caused by massive ascites. The patient underwent exploratory laparotomy, and hemorrhagic ascites (5500 mL) was drained. She had a normal-sized uterus, and the bilateral ovaries could not be observed because of extensive adhesion in the abdominal cavity. Endometriosis was diagnosed by histopathological evaluation of the omental biopsy, and this was considered to be the cause of ascites. After laparotomy, she had recurrence of ascites. For the next 8 years, the patient was treated conservatively with gonadotropin-releasing hormone agonist therapy and drainage during the intermittent periods followed by DNG administration. She has been treated continuously with DNG for 1 year with no recurrence of ascites. DNG could be an effective treatment for recurrent ascites associated with endometriosis, especially when surgical therapy is undesirable.
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References (9)
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- Pathophysiology of Cyclic Hemorrhagic Ascites and Endometriosis via openalex
- The inhibitory effect of dienogest, a synthetic steroid, on the growth of human endometrial stromal cells in vitro via openalex
- W6802283461 via openalex
Cited by (10)
- Treatment and fertility outcomes of moss-like endometriosis with hemorrhagic ascites: A case report 2025
- Fatal complications during pregnancy and delivery in women with profound endometriosis infiltrates: what is new in general clinical practice 2023
- Clinicopathological Characteristics and Outcomes of Patients With Endometriosis-Related Hemorrhagic Ascites: An Updated Systematic Review of the Literature 2022
- Peritoneal endometriosis presenting as fever of unknown origin, ascites and peritoneal miliary spread: A rare case report and review of the literature 2022
- Clinical Presentation and Management of Endometriosis-Related Hemorrhagic Ascites: A Case Report and Systematic Review of the Literature 2021
- Novel triple therapy for hemorrhagic ascites caused by endometriosis: A case report 2020
- Novel triple therapy for hemorrhagic ascites caused by endometriosis: A case report 2020
- Massive recurrent hemoperitoneum with encapsulating peritonitis: another enigmatic clinical feature of endometriosis 2019
- Ascites and Encapsulating Peritonitis in Endometriosis: a Systematic Review with a Case Report 2018
- Endometriosis and Ascites: A Strategy to Achieve Pregnancy 2015
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