Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium Emergency Medicine Residency, San Antonio Military Medical Center, Fort Sam Houston, TX, USA.
Am J Emerg Med. 2013 Jan;31(1):272.e1-3. doi: 10.1016/j.ajem.2012.05.008. Epub 2012 Jul 16.
Hemorrhagic ascites due to endometriosis is an exceedingly uncommon diagnosis rarely reported in the medical literature. We present a case of a 27-year-old woman who presented to the emergency department for flank and neck pain and was found to be hypotensive with massive hemorrhagic ascites and severe anemia. After emergency department resuscitation and hospitalization, her condition was found to be due to complications of endometriosis. A paracentesis of more than 4000 mL of bloody ascitic fluid revealed no evidence of cancer, and she was discharged on hospital day 3 with hormone therapy and no recurrence of symptoms upon outpatient follow-up. This case illustrates the clinical management, diagnostic approach, and underlying etiology of an infrequent but life-threatening complication of endometriosis.
由于子宫内膜异位症导致的血性腹水是一种极为罕见的诊断，在医学文献中鲜有报道。我们报告了一例 27 岁女性患者，因侧腰痛和颈部疼痛就诊于急诊科，被发现血压低伴有大量血性腹水和严重贫血。在急诊科复苏和住院治疗后，发现其病情是由子宫内膜异位症的并发症引起的。对超过 4000 毫升血性腹水进行的一次腹腔穿刺术未发现癌症证据，她在住院第 3 天出院，接受激素治疗，门诊随访时无症状复发。本例说明了子宫内膜异位症这一罕见但危及生命的并发症的临床管理、诊断方法和潜在病因。
