Spitzer M, Benjamin F
Department of Obstetrics & Gynecology, Queens Hospital Center, Jamaica, New York 11432, USA.
Obstet Gynecol Surv. 1995 Aug;50(8):628-31. doi: 10.1097/00006254-199508000-00024.
Ascites is a rare but important complication of endometriosis because it mimics ovarian cancer. Most cases occur in nulliparous young black women and present with massive ascites. Treatment is effected by ablation of ovarian function by surgery, radiotherapy, or suppression of endometriosis by endocrine therapy. The pathogenesis is unknown. In this paper, we present a case report and review of the other 19 cases in the literature. Because of the age of most of these women, endocrine therapy is preferred rather than castration. The majority of symptoms and signs of endometriosis are well known, including pelvic pain, dysmenorrhea, dyspareunia, infertility, and pelvic tenderness with or without masses. However, it is seldom appreciated that the disease can be a cause of, and can present with ascites, often massive and recurrent. It is important for gynecologists and oncologists to be aware of this entity because the presence of ascites with abdominal and/or pelvic masses and weight loss immediately suggests the diagnosis of malignancy, and the possibility of endometriosis is rarely considered. We are reporting a case of endometriosis causing massive and recurrent ascites, along with a review of the literature and a discussion of the epidemiology, pathogenesis, and management of this disorder.
腹水是子宫内膜异位症一种罕见但重要的并发症，因为它酷似卵巢癌。大多数病例发生在未生育的年轻黑人女性中，表现为大量腹水。治疗方法包括通过手术、放疗消除卵巢功能，或通过内分泌疗法抑制子宫内膜异位症。其发病机制尚不清楚。在本文中，我们报告了一例病例，并对文献中其他19例病例进行了综述。由于这些女性大多年龄较轻，因此更倾向于采用内分泌疗法而非去势手术。子宫内膜异位症的大多数症状和体征是众所周知的，包括盆腔疼痛、痛经、性交困难、不孕以及伴有或不伴有肿块的盆腔压痛。然而，人们很少认识到该疾病可能是腹水的病因，并且可能表现为腹水，通常是大量且反复出现的。妇科医生和肿瘤学家了解这一情况很重要，因为出现腹水并伴有腹部和/或盆腔肿块以及体重减轻会立即让人想到恶性肿瘤的诊断，而很少会考虑到子宫内膜异位症的可能性。我们报告了一例导致大量反复腹水的子宫内膜异位症病例，并对文献进行了综述，同时讨论了该疾病的流行病学、发病机制和治疗方法。
