Mangal R, Taskin O, Nezhat C, Franklin R
Woman's Hospital of Texas and Division of Reproductive Endocrinology, Baylor College of Medicine, Houston, Texas, USA.
J Reprod Med. 1996 Jan;41(1):64-6.
Endometriosis has been observed in 8-15% of reproductive age women and is commonly found in pelvic and nonpelvic organs. Despite its widespread prevalence, the etiology remains obscure.
A 22-year-old woman with intractable epigastric and pelvic pain who was treated previously by laser ablation for pelvic and diaphragmatic endometriosis was referred to our clinic. The patient received leuprolide acetate for six months, but the symptoms did not improve. Second-look laparoscopy revealed deep endometriotic spots involving both the diaphragms, exactly in the line of the left ventricle. With visualization, endometriosis was excised in total with the help of hydrodissection and CO2 vaporization.
As in pelvic endometriosis, therapy for extrapelvic endometriosis consists of surgical and hormonal manipulation following the diagnosis. The importance of extreme caution, meticulous surgery and cardiothoracic consultation when treating the diaphragmatic surface cannot be overemphasized.
子宫内膜异位症在8% - 15%的育龄妇女中被观察到，常见于盆腔和非盆腔器官。尽管其患病率很高，但其病因仍不清楚。
一名22岁患有顽固性上腹部和盆腔疼痛的女性，此前因盆腔和膈肌子宫内膜异位症接受过激光消融治疗，现转诊至我院。患者接受了六个月的醋酸亮丙瑞林治疗，但症状并未改善。二次腹腔镜检查发现深部子宫内膜异位病灶累及双侧膈肌，正好位于左心室线上。在可视情况下，借助水分离和二氧化碳汽化术将子宫内膜异位症病灶完全切除。
与盆腔子宫内膜异位症一样，盆腔外子宫内膜异位症的治疗包括诊断后的手术和激素治疗。在治疗膈肌表面时，务必极度谨慎、进行细致的手术并咨询心胸外科医生，其重要性无论如何强调都不为过。
