Laparoscopic Management of Phrenic Endometriosis

Cássia Gisele Terrassani Silveira, Admir Agic, Markus Kleemann, Hartmut Merz, Daniela Hornung
In: Journal of Endometriosis · 2011 · vol. 3(4) , pp. 213–217 · doi:10.5301/je.2012.9069 · W1792775784
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This report details the successful laparoscopic resection of a phrenic endometriotic lesion causing cyclical right upper abdominal pain in a reproductive-age woman.

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Abstract

Introduction Extrapelvic endometriosis is a rare condition typically associated with variable symptomatology and complex diagnosis. Case report: Here, we report a rare case of phrenic endometriosis manifested insidiously in a woman of reproductive age after a prolonged history of endometriosis with several surgical interventions, including laparoscopic bowel resection a few months ago. The patient presented with menstrual-related, cyclical, right upper abdominal pain. Results Accurate surgical inspection during the laparoscopic procedure enabled the identification and full resection of a deep infiltrating endometriotic lesion growing from the peritoneum into the phrenic tissue, which was suspected by symptomatology. No pulmonary complications were detected before or after surgery except for a small right-sided pneumothorax, which did not require drainage and disappeared spontaneously after five days. Conclusions The rare case reported here emphasizes the importance of a very exact conversation with the patient before surgery, a systematic and accurate surgical exploration for the diagnosis, and the successful laparoscopic treatment of a symptomatic phrenic disease in a woman with a longstanding history of endometriosis.

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endometriosis

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