Shabeerali TU, Rajan R, Kuruvilla AP, Noronha S, Krishnadas D, Shenoy KT, Manjula M, Shenoy S, Raji NL. Hemorrhagic ascites: are we missing endometriosis?
Indian J Gastroenterol 2012;
31:195-7. [PMID:
22763897 DOI:
10.1007/s12664-012-0221-1]
[Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 06/18/2012] [Indexed: 02/04/2023]
Abstract
Peritoneal tuberculosis, carcinomatosis and pancreatic ascites are often considered as differential diagnosis of hemorrhagic ascites. Endometriosis can rarely present as hemorrhagic ascites and closely mimic these conditions. When this occurs without common clinical features of endometriosis, it can create a diagnostic challenge to the treating physician. We present three patients with endometriosis who presented with hemorrhagic ascites; two of them did not have gynecological symptoms or significant pelvic disease. These patients were evaluated several times in many centers and even received multiple courses of anti-tuberculous treatment. The diagnosis was made by histologic examination of parietal peritoneum obtained by laparoscopy or laparotomy. The diagnosis was missed possibly because of the atypical presentation, lack of clinical suspicion and incomplete assessment. In conclusion, this potentially treatable condition should be considered as a differential diagnosis for hemorrhagic ascites in a premenopausal woman.
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