Recurrent Hemoperitoneum During Pregnancy in Large Deep Endometriosis Infiltrating the Parametrium

Emanuela Stochino Loi, Stochino Loi E, Darwish B, Basma Darwish, Abo C, Carole Abo, A. Millischer, Anne-Elodie Millischer-Bellaiche, Millischer-Bellaiche AE, Stefano Angioni, Horace Roman
Journal of minimally invasive gynecology · 2016 · vol. 23(4) , pp. 643–646 · doi:10.1016/j.jmig.2016.01.018 · PMID:26826678 · W2278804566
article OA: closed CC0 ⤵ 8 in-corpus citations
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A woman experienced recurrent hemoperitoneum during pregnancy due to large deep endometriosis infiltrating the parametrium.

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Abstract

We present the case of a young woman at 16 weeks' gestation who presented to a peripheral hospital with severe recurrent hemoperitoneum related to severe deep endometriosis infiltrating the left parametrium. She underwent 2 surgical open procedures in emergency, followed by pregnancy loss. Deep endometriosis infiltrated the rectum, the vagina, and the left parametrium, leading to stenosis of the left ureter and advanced destruction of the left kidney. Ovarian reserve was low with an antimullerian hormone level at .6 ng/mL. To improve endometriosis-related symptoms and preserve fertility, a laparoscopic conservative rectal and ureteral management was proposed with an aim to relieve symptoms, avoid further destruction of the left kidney, preserve the right splanchnic nerves and inferior hypogastric plexus, and enhance spontaneous conception. We performed a combined vaginal-laparoscopic approach that consisted of vaginal infiltration resection, adhesiolysis, rectal shaving, ureterolysis, and restoration of the permeability of the fallopian tubes. Seven months after surgery the patient spontaneously conceived and is doing well.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Hemoperitoneum Adult Colpotomy Colpotomy Endometriosis Endometriosis Female Hemoperitoneum Hemoperitoneum Humans Infertility, Female Infertility, Female Kidney Diseases Kidney Diseases Laparoscopy Laparoscopy Organ Sparing Treatments Organ Sparing Treatments Peritoneum

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (20)

Cited by (8)

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europepmc
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