Lin Jiun-Nong, Lin Hsing-Lin, Huang Chun-Kai, Lai Chung-Hsu, Chung Hsing-Chun, Liang Shiou-Haur, Lin Hsi-Hsun
Department of Medicine, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan.
J Emerg Med. 2010 Jan;38(1):30-2. doi: 10.1016/j.jemermed.2008.03.031. Epub 2008 May 20.
Endometriosis is defined as the presence of ectopic foci of endometrial tissue outside the uterine cavity. Many patients are asymptomatic, but others present protean symptoms, including headache, cyclic hemoptysis, pleural effusion, and ascites depending on the endometrial implantation sites. Although massive ascites has been reported as a manifestation of endometriosis, hypovolemic shock is unusual. We report a case of endometriosis presenting as shock and bloody ascites to show that endometriosis can result in acute abdomen with shock. A 29-year-old female presented to our Emergency Department (ED) complaining of light-headedness and palpitations. Examination suggested hypovolemic shock. Ultrasonography revealed massive ascites and paracentesis showed bloody ascites. Exploratory laparoscopy showed endometriosis over the left broad ligament. After fluid resuscitation and electrocauterization of the endometriosis, the patient's condition stabilized, and she was discharged 5 days after admission. This case is presented to raise awareness that endometriosis can present with hypovolemic shock.
子宫内膜异位症的定义是子宫腔外存在子宫内膜组织的异位病灶。许多患者无症状，但其他患者会出现多种症状，包括头痛、周期性咯血、胸腔积液和腹水，具体取决于子宫内膜的植入部位。虽然大量腹水已被报道为子宫内膜异位症的一种表现，但低血容量性休克并不常见。我们报告一例以休克和血性腹水为表现的子宫内膜异位症病例，以表明子宫内膜异位症可导致伴有休克的急腹症。一名29岁女性因头晕和心悸就诊于我们的急诊科。检查提示低血容量性休克。超声检查显示大量腹水，腹腔穿刺抽出血性腹水。 exploratory laparoscopy显示左侧阔韧带存在子宫内膜异位症。经过液体复苏和对子宫内膜异位症进行电灼治疗后，患者病情稳定，入院5天后出院。呈现此病例是为了提高对子宫内膜异位症可表现为低血容量性休克的认识。 （注：原文中“Exploratory laparoscopy”直译为“探索性腹腔镜检查”，这里可能是指“腹腔镜探查术”，按照更符合语境的意思翻译了。）
