Y Shek1, J E De Lia, R A Pattillo. 1. Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, USA.
Abstract
BACKGROUND: Although endometriosis is generally confined to the pelvis, it may occur at remote sites with unusual manifestations. Rare examples include pulmonary endometriosis and endometriosis associated with ascites. These complications represent diagnostic and therapeutic dilemmas, especially when both occur concurrently in the same patient. CASE: A 21-year-old nulligravida had a history of endometriosis and complained of severe dyspnea and weight loss. Pleural effusion and pelvic ascites associated with recurrent endometriosis were found. The patient was treated with thoracentesis and nafarelin acetate nasal spray. A remarkable improvement in her condition occurred, and the side effects of the spray were minimal during treatment. CONCLUSION: Gonadotropin-releasing hormone agonist therapy is recommended as the initial treatment for endometriotic ascites and/or pleural effusion.
BACKGROUND: Although endometriosis is generally confined to the pelvis, it may occur at remote sites with unusual manifestations. Rare examples include pulmonary endometriosis and endometriosis associated with ascites. These complications represent diagnostic and therapeutic dilemmas, especially when both occur concurrently in the same patient. CASE: A 21-year-old nulligravida had a history of endometriosis and complained of severe dyspnea and weight loss. Pleural effusion and pelvic ascites associated with recurrent endometriosis were found. The patient was treated with thoracentesis and nafarelin acetate nasal spray. A remarkable improvement in her condition occurred, and the side effects of the spray were minimal during treatment. CONCLUSION:Gonadotropin-releasing hormone agonist therapy is recommended as the initial treatment for endometriotic ascites and/or pleural effusion.