Endometriosis associated with hemothorax.
Bloody pleural effusion is rarely associated with endometriosis. To effectively treat this condition, it is important to differentiate the malady from other common diseases such as malignancy or tuberculosis. We describe the case of a 40-year-old multiparous female featuring right-sided hemothorax presenting with right shoulder pain and progressive shortness of breath for the preceding 2 months. Thoracoscopy disclosed grossly negative findings apart from multiple small pores in the right hemi-diaphragm with blood clots within them. Examination of the thoracoscopic biopsy specimens showed chronic pleuritis without evidence of malignancy or tuberculosis. Pelvic endometriosis was considered a possible diagnosis according to the results of abdominal computed tomography (CT) scan, transvaginal sonography, and the results of dilatation and curettage. Periodic episodes of symptoms concurrent with menstruation led to the suspicion of a relationship between these conditions in our patient. Despite the patient undergoing an abdominal total hysterectomy and adhesiolysis without salpingo-oophorectomy, recurrent right-sided bloody pleural effusion developed 1.5 months subsequent to surgery. As a consequence, danazol (400 mg/day) was maintained because of the endometriosis associated with pleural effusion. One year of regular follow-up later, there was no evidence of recurrent pleural effusion. We considered that the bloody pleural fluid arose via seepage from the pelvic endometriosis through the pores of the right hemi-diaphragm during menstruation.
Lee
Hung-Tsung
HT
Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
Wang
Hong-Chung
HC
Huang
Ia-Tang
IaT
Chang
Huang-Chou
HC
Lu
Jau-Yeong
JY
D000328:Adult; D018394:CA-125 Antigen / Q000097:blood; D004715:Endometriosis / Q000150:complications*; D005260:Female; D006491:Hemothorax / Q000209:etiology*; D006801:Humans; D010996:Pleural Effusion / Q000209:etiology
D018394:CA-125 Antigen