Severe hemoperitoneum due to endometriosis in a non-pregnant woman under dienogest therapy: a case report

Abstract

Endometriosis is a chronic, estrogen-dependent, inflammatory disease that mainly affects women of reproductive age and is defined by the presence of endometrial glands and stroma at ectopic sites. Spontaneous hemoperitoneum due to bleeding of pelvic endometriotic foci represents a very rare and severe complication of endometriosis, although most cases described in literature regard pregnant women. We hereby present a case of a severe hemoperitoneum in a non-pregnant, 42 years old woman, under dienogest therapy for deep endometriosis. This life-threatening condition was promptly managed by performing an exploratory laparoscopy where the source of bleeding was found and hemostasis successfully achieved.

Bleeding from pelvic endometriotic foci ought to be considered in the differential diagnosis of gynecological causes of acute abdomen and hemoperitoneum, even under medical therapy.

摘要

子宫内膜异位症是一种慢性、依赖雌激素的炎症性疾病, 主要影响育龄妇女, 其定义为子宫内膜腺体和间质出现在子宫体以外的部位。由盆腔子宫内膜异位症病灶出血引起的自发性腹腔积血是子宫内膜异位症一种非常罕见和严重的并发症, 尽管文献中描述的大多数病例是孕妇。我们在此报告一位未怀孕的42岁妇女, 因深部子宫内膜异位正在接受地诺孕素治疗。通过腹腔镜探查发现了出血点并成功止血, 及时处理了这一危及生命的情况。

盆腔子宫内膜异位症出血时应考虑妇科原因所致急腹症和腹腔积血及药物治疗引起的出血。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Acute abdomen
• Dienogest
• Endometriosis
• Hemoperitoneum
• Laparoscopy

Disclosure statement

No potential conflict of interest was reported by the authors.