Endométriose et ascite hémorragique massive récidivante

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

“…However, in this review, less than half of the study population were found to have ovarian endometriotic cysts, and only four out of 36 of these cysts were ruptured. Alternative hypotheses such as alterations in vascular permeability, lymphatic channel obstruction, as well as individual variations in susceptibility to the disease may be explored [44,49,83,84].…”

“…The rubor of ascites may be due to increased angiogenesis seen in endometriosis. Erosions from affected friable soft tissue, serosal, peritoneal surfaces, and implants cause micro-bleeding or frank bleeding, leading to the hemorrhagic character of ascites [49,84]. Pleural effusions associated with the hemorrhagic ascites may be due to several mechanisms.…”

“…The recurrence rate observed at the time of presentation or after initial management was 36.90% (31/84), while that after definitive surgery and/or ovarian function suppression was 8.33% (7/84). Five of these cases reported significant ascites upon the cessation of GnRH therapy [35,49,50,62] or upon shifting from GnRH to progestogen therapy [15]. The other two had reaccumulating minimal ascites while on oral COC [35] or oral progestogen [70].…”

Placental Abnormalities

“…The placenta is thin, yet deeply implanted in the endometrium, which places it at risk for forming placenta accreta and previa, with the subsequent sequellae of the aforementioned conditions. Aside from the risks associated with placenta previa and accreta, placenta membranacea is also at risk for recurrent antepartum bleeding, intra-uterine growth retardation (IUGR), miscarriage, preterm labor, intrauterine fetal demise (IUFD), retained placenta after delivery, and postpartum hemorrhage [33][34][35].…”