Fortier D, Dedecker F, Gabriele M, Graesslin O, Barau G
Service de gynécologie-obstétrique, groupe hospitalier Sud-Réunion, avenue François-Mitterrand, BP 350, 97448 Saint-Pierre cedex, La Réunion, France.
Gynecol Obstet Fertil. 2005 Jul-Aug;33(7-8):508-10. doi: 10.1016/j.gyobfe.2005.05.014.
Massive ascites associated with pelvic endometriosis is an uncommon combination. Pleural effusion may rarely occur. Fourteen cases are reported in the literature. We report the case of a black nulligravida woman followed for a primary infertility. Endometriosis was suspected in presence of increasing dysmenorrhea, cystic adnexal masse, umbilical nodes and ascites. The diagnosis was confirmed at exploratory laparoscopy. The patient had been followed for assisted procreation for six years and had undergone a conservative laparoscopic surgery never described. After several ascites recurrences, the pathology was resolved by Gonadotropin-releasing hormone agonist therapy. But a right pleural effusion with ascites occurred following a bad therapeutic observance. This complication reveals an early pregnancy never reported for this exceptional pathology. A conservative management allowed this unique case of well outcoming pregnancy. The possible pathogenesis of ascites and pleural effusion are explored and recommendations for diagnosis and treatment options are discussed.
大量腹水合并盆腔子宫内膜异位症是一种不常见的组合。胸腔积液很少发生。文献报道了14例。我们报告一例原发性不孕症的黑人未孕女性病例。因痛经加重、附件囊性肿块、脐部结节和腹水怀疑患有子宫内膜异位症。在探查性腹腔镜检查时确诊。该患者接受辅助生殖治疗6年,曾接受过从未描述过的保守性腹腔镜手术。多次腹水复发后,通过促性腺激素释放激素激动剂治疗使病情得到缓解。但由于治疗依从性差,出现了右侧胸腔积液伴腹水。这种并发症揭示了这种特殊病理从未报道过的早期妊娠。保守治疗使这例独特的病例成功妊娠。探讨了腹水和胸腔积液可能的发病机制,并讨论了诊断和治疗选择的建议。