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Related Concept Videos

Ascites01:19

Ascites

DefinitionAscites is the buildup of fluid inside the peritoneal cavity. It occurs when fluid moves out of the vascular system faster than the peritoneal lymphatics can remove it. This fluid shift is most commonly seen in liver cirrhosis but can also appear in several other systemic disorders.EtiologyCirrhosis remains the leading cause of ascites. Other conditions that can contribute include:Heart failureConstrictive pericarditisAbdominal cancersNephrotic syndromeSevere protein–calorie...
Oogenesis02:07

Oogenesis

In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Appendicitis01:19

Appendicitis

Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
Cirrhosis I: Introduction01:23

Cirrhosis I: Introduction

Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...

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Related Experiment Video

Updated: May 20, 2026

Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity
07:20

Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity

Published on: December 21, 2012

Hemorrhagic ascites: are we missing endometriosis?

T U Shabeerali1, Ramesh Rajan, A P Kuruvilla

  • 1Department of Surgical Gastroenterology, Medical College, Trivandrum, 695 011 Kerala, India. drshabeeralitu@yahoo.com

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|July 6, 2012
PubMed
Summary

Endometriosis can rarely cause hemorrhagic ascites, mimicking other serious conditions. Consider endometriosis in premenopausal women with unexplained hemorrhagic ascites, even without typical symptoms.

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Area of Science:

  • Gastroenterology
  • Gynecology
  • Pathology

Background:

  • Hemorrhagic ascites has a broad differential diagnosis including peritoneal tuberculosis, carcinomatosis, and pancreatic ascites.
  • Endometriosis is an uncommon cause of hemorrhagic ascites, often presenting atypically.
  • Atypical presentations can lead to diagnostic challenges and delayed or incorrect diagnoses.

Observation:

  • Three cases of premenopausal women presenting with hemorrhagic ascites due to endometriosis are described.
  • Two patients lacked typical gynecological symptoms or significant pelvic disease.
  • Patients underwent extensive evaluations and received empirical anti-tuberculous treatment before diagnosis.

Findings:

  • Diagnosis of endometriosis presenting as hemorrhagic ascites was confirmed histologically via peritoneal biopsy.
  • Atypical clinical presentation and lack of suspicion contributed to diagnostic delays.
  • Laparoscopy or laparotomy provided definitive tissue for histopathological examination.

Implications:

  • Endometriosis should be included in the differential diagnosis for premenopausal women with hemorrhagic ascites.
  • Increased clinical suspicion is crucial for diagnosing rare presentations of endometriosis.
  • Early and accurate diagnosis of endometriosis-related ascites can prevent unnecessary treatments and improve patient outcomes.