PDF(Pubmed)
Abstract：
The presence of ascites is a common clinical presentation in gynecologic oncology patients. Hemorrhagic ascites (HA) due to endometriosis is a rare presentation that can be easily misdiagnosed as ovarian malignancies. The present study aims to update the currently available knowledge on the characteristics of patients presenting with HA due to endometriosis. A systematic search was conducted for articles published from January 2000 to July 2020 using the Medline, Scopus, and Google Scholar databases along with the references of the full-text articles retrieved. Papers describing cases of women over 18 years with or without previous history of endometriosis were assessed. Only cases with histologically proven hemorrhagic ascites of endometriosis origin were included. Twenty-nine studies (27 case reports and two case series) comprising 32 patients were evaluated. The mean patients\' age was 32 years, while six of the patients had a previous history of endometriosis. The mean amount of drained ascitic fluid was 4,200 mL, whereas three patients underwent thoracentesis due to pleural effusions. The treatment options included not only medical but also surgical therapies. Fertility preservation was achieved in 27 patients, while two of them achieved pregnancy with in vitro fertilization (IVF) techniques. Endometriosis-related hemorrhagic ascites is a relatively rare expression of the disease. Endometriosis-related hemorrhagic ascites should be considered in the differential diagnosis (DD) of women with ascites and clinical suspicion of endometriosis. The available literature is limited to case reports and case series and thus indicates further research in the field to decode the pathophysiology of the disease and decide on the optimal treatment.
摘要：
腹水的存在是妇科肿瘤患者的常见临床表现。子宫内膜异位症引起的出血性腹水（HA）是一种罕见的表现，很容易被误诊为卵巢恶性肿瘤。本研究旨在更新有关因子宫内膜异位症而出现HA的患者特征的现有知识。使用Medline对2000年1月至2020年7月发表的文章进行了系统的搜索，Scopus,和GoogleScholar数据库以及检索到的全文文章的参考文献。评估了描述18岁以上有或没有子宫内膜异位症病史的女性病例的论文。仅包括经组织学证实为子宫内膜异位症起源的出血性腹水的病例。对包括32例患者的29项研究（27例病例报告和2例病例系列）进行了评估。病人的平均年龄是32岁,其中6例患者有子宫内膜异位症病史。排出的腹水平均量为4,200mL,而3例患者因胸腔积液行胸腔穿刺术。治疗选择不仅包括药物治疗，还包括手术治疗。在27例患者中实现了生育力保留，而其中两人通过体外受精（IVF）技术实现了怀孕。子宫内膜异位症相关性出血性腹水是一种较为少见的表现疾病。子宫内膜异位症相关的出血性腹水应在腹水和临床怀疑子宫内膜异位症的女性的鉴别诊断（DD）中考虑。现有文献仅限于病例报告和病例系列，因此表明该领域的进一步研究以解码疾病的病理生理学并决定最佳治疗方法。
