Clinical Presentation and Management of Endometriosis-Related Hemorrhagic Ascites: A Case Report and Systematic Review of the Literature

Chan-Tiopianco, Mareesol; Chao, Wei‐Ting; Ching, Patrick R; Jiang, Ling-Yu; Wang, Peng-Hui; Chen, Yi Jen

doi:10.7759/cureus.15828

Cited by 3 publications

(15 citation statements)

References 73 publications

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“…6,7,9 Asian women developing endometriosis-linked ascites, such as in this case is very rare, with 16.13 % of the reported women being Asian, against the bulk of 69.35 % African descent. 4 These women were in fact more frequently nulliparous. The most common presenting complaint has been abdominal distension.…”

Section: Discussionmentioning

confidence: 97%

“…3 Cirrhosis of the liver is the most common aetiology. 4 Conversely, 20% of cases are not linked to liver cirrhosis. 5 In developed countries, tumours and heart diseases are the predominant causes, while developing countries are mainly concerned with infectious diseases, among which tuberculosis is the leading association.…”

Section: Discussionmentioning

confidence: 99%

“…Their symptoms overlap, with poor appetite and weight loss described in one-third of reported cases of endometriosis associated ascites, the fourth most common symptom. 4,9 Thus, the diagnosis of this clinical entity is made after the exclusion of other more common causes. The cases reported had undergone abdominal paracentesis for cytological analysis, and tissue biopsy for histopathology, to exclude malignant cells and tuberculosis infection.…”

Section: Discussionmentioning

confidence: 99%

“…The most common presenting complaint has been abdominal distension. 4,9 Reported ascites has predominantly been massive, averaging 4 litres, and as much as 7 litres in cases, with a high risk of recurrence. 4,6,7,9 Acute recurrences have been as early as eight days.…”

Section: Discussionmentioning

confidence: 99%

“…Recognising this diagnosis is further complicated by the presence of ascites in other circumstances like malignancy, infection, cirrhosis, or trauma. 4 Thus the purpose of this case report is to propose as to how a diagnosis of ascites secondary to endometriosis could be suspected in Asian women and what would be its predictable course and management options.…”

Section: Introductionmentioning

confidence: 99%

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Endometriosis presenting as relapsing haemorrhagic ascites in a South Asian woman: a case report

Ahmed,

Chughtai

2023

J Pak Med Assoc

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Endometriosis presenting as ascites is a rare entity, and is more so in women of Asian ethnicity. Less than a hundred cases have been reported worldwide. Majority of patients present with abdominal distension and pain, draining massive blood stained serosanguineous fluid. This hinders future fertility prospects of these women. Ovarian suppression has been employed as a successful treatment, followed by definitive surgical treatment, such as bilateral salpingo-oophorectomy, to end the possibility of recurrences, which are otherwise always possible. We present the case of a woman of reproductive age, seeking fertility treatment, who had a more subtle presentation of moderate, but relapsing ascites of unknown origin in the past two years. Diagnostic laparoscopy and histopathology of the peritoneal deposits suggested endometriosis. Her ovarian function was suppressed, and she is currently underway of assisted reproduction for achieving a pregnancy. Keywords: Endometriosis, ascites, ovarian suppression.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Endometriosis presenting as relapsing haemorrhagic ascites in a South Asian woman: a case report

Ahmed,

Chughtai

2023

J Pak Med Assoc

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Thoracic endometriosis masquerading as Meigs' syndrome in a young woman: A case report and literature review

Bahall

Barry²,

Singh³

2022

Case Reports in Women's Health

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Abdominal Cocoon and Recurrent Haemorrhagic Ascites, Unexpected Findings in Endometriosis: A Case Report and Review of Literature

Jamil,

Jamil

2024

EMJ

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Introduction: The presentation of endometriosis as massive haemorrhagic ascites and the presence of concurrent encapsulating sclerosing peritonitis is extremely rare in medical literature. This presentation warrants a strong suspicion for endometriosis especially in a nulliparous, reproductive-age woman. Case Report: A 22-year-old woman presenting with nonspecific abdominal discomfort, distension, massive ascites, dysmenorrhea, anaemia, and mild weight loss is reported here. Diagnosis: Based on biopsy results at laparotomy, negative Tuberculosis cultures, a poor response to the anti-tuberculosis therapy, and, finally, an excellent response to combined oral contraceptive pills, endometriosis was confirmed as the diagnosis of exclusion in this case. Interventions and outcomes: The patient received medical treatment for endometriosis and had an excellent response to treatment. Methods: The team conducted a thorough literature review on PubMed/MEDLINE, Cochrane, and Science Direct and shortlisted 13 highly relevant articles for the case report. The patient provided informed written consent for the publication of this case report, with no patient-identifying information included in the article. The figures in the case report have not been published elsewhere, so the authors did not require copyright permission. Conclusion: This is one of the few cases reported in the literature in which endometriosis presented with haemorrhagic ascites and sclerosing peritonitis. Endometriosis should be considered a differential diagnosis in a nulliparous, reproductive-age female who presents with massive recurrent haemorrhagic ascites.

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Clinical Presentation and Management of Endometriosis-Related Hemorrhagic Ascites: A Case Report and Systematic Review of the Literature

Abstract: Chan-Tiopianco et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 3 publications

References 73 publications

Endometriosis presenting as relapsing haemorrhagic ascites in a South Asian woman: a case report

Endometriosis presenting as relapsing haemorrhagic ascites in a South Asian woman: a case report

Thoracic endometriosis masquerading as Meigs' syndrome in a young woman: A case report and literature review

Abdominal Cocoon and Recurrent Haemorrhagic Ascites, Unexpected Findings in Endometriosis: A Case Report and Review of Literature

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