[Endometriosis with ascites and pleural effusion: a case report]

Area of Science:

• Reproductive Medicine
• Gynecologic Oncology
• Medical Case Reports

Background:

• Pelvic endometriosis is a common condition, but massive ascites and pleural effusion are rare presentations.
• Endometriosis-associated ascites and pleural effusion have been reported in only 14 cases in the literature.
• This study focuses on a nulligravida woman with primary infertility and suspected endometriosis.

Observation:

• The patient presented with increasing dysmenorrhea, cystic adnexal masses, umbilical nodules, and massive ascites.
• Exploratory laparoscopy confirmed the diagnosis of endometriosis.
• The patient underwent a novel conservative laparoscopic surgery and received assisted reproduction treatments.

Findings:

• Despite conservative management and Gonadotropin-releasing hormone agonist therapy, the patient experienced recurrent ascites.
• A rare complication of early pregnancy occurred, presenting as right pleural effusion with ascites, a previously unreported association with endometriosis.
• Conservative management led to a successful pregnancy outcome in this unique case.

Implications:

• This case expands the understanding of rare endometriosis complications, including pregnancy in the presence of ascites and pleural effusion.
• It underscores the importance of considering pregnancy in women with endometriosis and unexplained ascites/pleural effusion.
• The successful conservative management offers insights into therapeutic options for similar complex cases.