• C C Dias, J M Andrade, R A Ferriani, M G Villanova, and R S Meirelles.
• Department of Obstetrics and Gynecology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil.
• J Reprod Med. 2000 Aug 1;45(8):688-90.

BackgroundEndometriosis associated with massive, bloody ascites is an unusual occurrence. This report draws attention to this condition as a complication of endometriosis, with the description of a case and a review of 31 others.CaseA 41-year-old, black nulligravida with massive, bloody ascites and a pelvic mass underwent laparotomy, and an intraoperative microscopic examination ruled out malignancy. The histologic report was compatible with endometriosis. The patient was treated with a GnRH analog, with progressive reduction of ascitic fluid and full remission after six months.ConclusionBloody ascites should be considered a complication of endometriosis, especially in nulliparous women of childbearing age with abdominal distention, a pelvic mass, dysmenorrhea, abdominal pain, weight loss and eventual pleural effusion, suggesting a diagnosis of ovarian malignancy.

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