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A Rare Presentation of Endometriosis with Massive Haemorrhagic Ascites: A Case Report

Neha Varun and Renu Tanwar

Background: Endometriosis associated with massive haemorrhagic ascites is an exceedingly uncommon finding. In most of the cases, the presence of massive hemorrhagic ascites is associated with malignancies, hepatoma, tuberculosis or perforated viscous. This case report draws attention to this condition of massive hemorrhagic ascites as a complication of endometriosis. Case: A 25-year-old, nulligravida with massive haemorrhagic ascites and right adnexal mass in CT scan underwent laparotomy, and peroperatively three liters of hemoperitoneum was found with no signs of malignancy on examination of ovary. The histological report of abdominal peritoneum was compatible with an endometriosis. The patient was treated with a GnRH analogue in postoperative period with progressive reduction of ascitic fluid. Patient is on follow up. Conclusion: Haemorrhagic ascites should be considered as a complication of endometriosis, especially in nulliparous women of childbearing age group with abdominal distention, dysmenorrhea, abdominal pain and haemorrhagic ascites, suggesting a diagnosis of ovarian malignancy.