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Diaphragmatic endometriosis.

M J Cooper1, P Russell, P J Gallagher

  • 1King George V Hospital, Sydney, NSW. m_cooper@zip.com.au

The Medical Journal of Australia
|September 4, 1999
PubMed
Summary
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Endometriosis, a pelvic condition, can rarely occur in the upper abdomen. Surgical removal of a diaphragmatic endometriosis lesion relieved a patient's chronic shoulder pain, highlighting a rare extrapelvic manifestation.

Area of Science:

  • Reproductive Medicine
  • Surgical Pathology
  • Abdominal Surgery

Background:

  • Endometriosis is a common gynecological condition characterized by endometrial-like tissue outside the uterus.
  • While typically confined to the pelvic region, extrapelvic endometriosis can occur, albeit rarely.
  • Upper abdominal endometriosis is an exceptionally uncommon presentation.

Observation:

  • A patient presented with chronic, debilitating right shoulder tip pain.
  • The pain was refractory to conservative management and diagnostic workup.
  • Imaging and subsequent surgical exploration revealed a diaphragmatic lesion consistent with endometriosis.

Findings:

  • The patient was diagnosed with diaphragmatic endometriosis, a rare form of extrapelvic endometriosis.

Related Experiment Videos

  • Surgical excision of the diaphragmatic lesion led to complete resolution of the patient's shoulder tip pain.
  • This case underscores the importance of considering endometriosis in the differential diagnosis of unexplained chronic pain, even in extragenital locations.

    • Implications:

    • This case expands the known spectrum of endometriosis presentation.
    • It highlights the diagnostic challenge of extrapelvic endometriosis, particularly in extragenital sites like the diaphragm.
    • Successful surgical management suggests that complete excision is an effective treatment for diaphragmatic endometriosis causing referred pain.