title: Postparacentesis bilateral massive vulvar edema in a patient with severe ovarian hyperstimulation syndrome.
abstract: OBJECTIVE
  To report a case of bilateral massive vulvar edema following lower abdominal paracentesis in a patient with ovarian hyperstimulation syndrome.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  A 32-year-old woman with primary infertility.
  
  
  METHODS
  The patient underwent ovarian stimulation with leuprolide acetate, highly purified FSH, and hCG. Because of the development of severe ovarian hyperstimulation syndrome, bilateral paracentesis through the lower abdominal quadrants was performed.
  
  
  METHODS
  Treatment of ovarian hyperstimulation syndrome.
  
  
  RESULTS
  Development of bilateral massive vulvar edema 24 hours after lower abdominal paracentesis.
  
  
  CONCLUSIONS
  This case report suggests that lower abdominal paracentesis could be the cause of vulvar edema development in ovarian hyperstimulation syndrome, probably due to a fistulous tract created between the peritoneal cavity and the subcutaneous tissues.
authors.affiliation: First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece. vavillis@cc.fauth.gr
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Vavilis
authors.forename: Stergios
authors.initials: S
authors.lastname: Tzitzimikas
authors.forename: Theodoros
authors.initials: T
authors.lastname: Agorastos
authors.forename: Aristotelis
authors.initials: A
authors.lastname: Loufopoulos
authors.forename: Trifon
authors.initials: T
authors.lastname: Tsalikis
authors.forename: John N
authors.initials: JN
authors.lastname: Bontis
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D004487:Edema / Q000209:etiology* / Q000628:therapy; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage; D016471:Ovarian Hyperstimulation Syndrome / Q000209:etiology / Q000628:therapy*; D010062:Ovulation Induction / Q000009:adverse effects; D019152:Paracentesis / Q000009:adverse effects*; D014845:Vulvar Diseases / Q000209:etiology* / Q000628:therapy
chemical_list: D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D005640:Follicle Stimulating Hormone; D016729:Leuprolide