Symptomatic diaphragmatic endometriosis ten years after total abdominal hysterectomy.
BACKGROUND
Endometriosis is a disease that affects women, mostly in the age range of 25-35 years, and in most cases pelvic organs are involved. Involvement of the diaphragm after hysterectomy is extremely uncommon.


METHODS
A 50-year-old woman presented to our department with right upper-quadrant abdominal pain. Ten years before her admission, she underwent total hysterectomy and right salpingo-oophorectomy for a large leiomyomatous uterus. On evaluation, a right diaphragmatic lesion was identified by computed tomography. An explorative laparotomy was then performed, which revealed a 4-cm diaphragmatic cyst compressing the liver surface and containing thick chocolate-colored material. The lesion was totally excised. Pathological examination confirmed the diagnosis of endometriotic cyst.


CONCLUSIONS
The diagnosis of endometriosis involving the diaphragm with no evidence of disease in the pelvis 10 years after hysterectomy, although a rare situation, should be considered in the differential diagnosis of a symptomatic diaphragmatic lesion in a woman with a single functioning ovary.
Nahir
Barak
B
Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel.
Eldar-Geva
Talia
T
Alberton
Joseph
J
Beller
Uzi
U
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D001707:Biopsy, Needle; D003560:Cysts / Q000000981:diagnostic imaging; D003964:Diaphragm / Q000473:pathology; D004715:Endometriosis / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D007150:Immunohistochemistry; D007813:Laparotomy / Q000379:methods; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery*; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D018570:Risk Assessment; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery