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A systematic review: endometriosis presenting with ascites

Archives of Gynecology and Obstetrics volume 283, pages 513–518 (2011)Cite this article

Abstract

Background

The present review aims to increase the awareness of the gynecologists by analyzing all the case reports which refer to endometriosis presenting either with only ascites or with massive ascites with pleural effusion.

Methods

To conduct the present review, the CENTRAL (in the Cochrane Library, current issue), MEDLINE (Silver Platter, from 1950 to 2010), and EMBASE (from 1950 to 2010) electronic databases were searched. As a result, all the publications based on the keywords relating to the review topic were acquired.

Results

Since the description of first case in 1954, endometriosis-related ascites was reported to occur in a total of 63 women who were aged between 19 and 51 years. Approximately 63.0% of the recruited women for whom ethnicity was specified were of African origin (29 out of 46). Of the 50 subjects with known obstetric history, 41 (82.0%) were nulliparous. Abdominal distention, anorexia/weight loss, abdominal pain, and menometrorrhagia were the most frequently encountered clinical symptoms, whereas pelvic mass was the most common physical finding. The serum concentrations of CA 125 were between 20 and 3,504 IU/ml for 19 women whose CA 125 levels were determined. Pleural effusion was also present in 38.1% of the reviewed subjects (24 out of 63). The clinical features of the women with endometriosis-related ascites and pleural effusion were similar to those of the women who had only endometriosis-related ascites.

Conclusion

Endometriosis-related ascites and/or pleural effusion refers to extensive disease with a high risk for recurrence which usually affects non-Caucasian, nulliparous women of reproductive age and leads to clinical symptoms resembling those of an ovarian malignancy. Therefore, clinicians should consider endometriosis in differential diagnosis of pelvic masses and also include endometriosis in diagnostic workup of ascites or pleural effusion.

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Acknowledgments

We acknowledge our colleagues for their help in the translation of non-English papers.

Conflict of interest

None.

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Affiliations

  1. Department of Gynecology, Dr. Zekai Tahir Burak Women Health Research and Education Hospital, Ankara, Turkey

    Tayfun Gungor, Mustafa Ozat & Mujdegul Zayifoglu Karaca

  2. Department of Obstetrics and Gynecology, Etlik Ihtisas Research and Education Hospital, Yunus Emre Mah, Dereboyu Sok. No: 71/2 Yenimahalle, 06170, Ankara, Turkey

    Mine Kanat-Pektas

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  1. Tayfun Gungor
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  2. Mine Kanat-Pektas
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  3. Mustafa Ozat
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Correspondence to Mine Kanat-Pektas.

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Gungor, T., Kanat-Pektas, M., Ozat, M. et al. A systematic review: endometriosis presenting with ascites. Arch Gynecol Obstet 283, 513–518 (2011). https://doi.org/10.1007/s00404-010-1664-1

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  • DOI: https://doi.org/10.1007/s00404-010-1664-1

Keywords

  • Ascites
  • Endometriosis
  • Pleural effusion