Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity. It generally involves the peritoneum, ovaries and rectovaginal septum. Its characteristic symptoms include @entity1834 , @entity2371 , deep @entity546 and @entity249 . It may also involve the gastrointestinal tract, urinary tract or extra abdominal sites, giving rise to a wide variety of clinical symptoms such as bloody stools, @entity548 , hemoptysis and @entity1143 during menstruation. Recurrent @entity548 secondary to @entity46 is an unusual occurrence, 41 cases have been reported since 1954. Here we report an additional case, in order to draw attention to this condition. A 28 years-old black nulligravida @entity1 was seen for the first time in april 2000 with a chief complaint of @entity249 . Her past medical history was unremarkable. She had regular menses but associated with severe @entity1834 . She also recalled abdominal and @entity2371 for several years. She underwent an ovulation induction with gonadotrophin, which resulted in a progressive @entity2371 . A first laparoscopy was performed, revealing @entity843 (10 I). Two years later the ascites recurred spontaneously. Ultrasound examination revealed suspect "para uterine masses". A second exploratory laparoscopy showed a @entity843 (71), and extensive adhesions. On histologic examination all specimens (peritoneal biopsies) were compatible with @entity46 and ruled out malignancy. Treatment with @entity1176 analog was performed and full remission was obtained after 6 months. One year later the ascites recurred again spontaneously, leading to a third laparoscopy in an other medical institution. Histologic examination showed endometrial stromal tissue and fibrous proliferation. Later she became pregnant after in vitro fertilization. In the first trimester of pregnancy, the pelvic ultrasound showed only a small effusion in the pouch of Douglas. Still, the ascites did not progress during pregnancy. The @entity1 was hospitalized from 27 to 33 weeks of gestational age for threatened labor, but she finally had a normal vaginal delivery at 36 weeks of gestational age. Four months later, she had no complaint, but the pelvic ultrasound showed the recurrence of the ascites. She will have a drainage. The future treatement will consists of @entity1176 analog for about six months, which will be relayed by a long term progestative therapy. A diagnosis of @entity46 should always be considered in middle-age @entity1 who presents with bloody ascites. Long follow-up is advisable for @entity1 who undergo conservative treatment because of thehigh risk of recurrence.

[Endometriosis with massive XXXX : a case report and review of the literature].

@entity1143 :: ('MESH:D010996', 'Disease') :: ['pleural effusion'] @entity1 :: ('9606', 'Species') :: ['women', 'woman', 'patients', 'patient'] @entity249 :: ('MESH:D007246', 'Disease') :: ['infertility'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhagic ascites', 'renal haemorrhage'] @entity1834 :: ('MESH:D004412', 'Disease') :: ['dysmenorrhea'] @entity843 :: ('MESH:D001201', 'Disease') :: ['voluminous ascites', 'voluminous bloody ascites'] @entity2371 :: ('MESH:D017699', 'Disease') :: ['pelvic pain', 'increase of pelvic pain'] @entity46 :: ('MESH:D004715', 'Disease') :: ['endometriosis'] @entity1176 :: ('MESH:D007987', 'Chemical') :: ['Gn RH', 'GnRH'] @entity546 :: ('MESH:D004414', 'Disease') :: ['dyspareunia']
@entity548 :: (MESH:D006470,Disease) :: ['hemorrhagic ascites']
