Ascites and Encapsulating Peritonitis in Endometriosis: a Systematic Review with a Case Report

Magalhães, Thais Fontes de; Augusto, Kathiane Lustosa; Mota, Livia Ponte; Costa, Arthur Ribeiro da; Puster, Rainardo Antonio; Bezerra, Leonardo Robson Pinheiro Sobreira

doi:10.1055/s-0038-1626700

Thais Fontes de Magalhães

Department of Gynecology, Universidade Federal do Ceará, Fortaleza, CE, Brazil

Kathiane Lustosa Augusto

Department of Gynecology, Universidade Federal do Ceará, Fortaleza, CE, Brazil

Department of Gynecology, Universidade de Fortaleza, Fortaleza, CE, Brazil

Livia Ponte Mota

Department of Internal Medicine, Universidade Federal do Ceará, Fortaleza, Brazil

Arthur Ribeiro da Costa

Department of Internal Medicine, Universidade Federal do Ceará, Fortaleza, Brazil

Rainardo Antonio Puster

Department of Internal Medicine, Universidade Federal do Ceará, Fortaleza, Brazil

Leonardo Robson Pinheiro Sobreira Bezerra

Department of Gynecology, Universidade Federal do Ceará, Fortaleza, CE, Brazil

Address for correspondence Thais Fontes de Magalhães, MD, Departmento de Ginecologia, Universidade Federal do Ceara, Rua Alexandre Barauna 949, Fortaleza, CE, 60430-160, Brazil (e-mail: thaisfdemagalhaes@gmail.com).

Contributors

Magalhaes TF, Augusto KL, Mota LP, Costa AR, Puster RA, and Bezerra LRPS contributed with the project and interpretation of data, writing of the article, critical review of the intellectual content and final approval of the version to be published.

Conflicts of Interest

The authors have no conflicts of interest to declare.

Search	Keywords
#1	peritoneal fibrosis OR encapsulating peritoneal sclerosis OR sclerosing encapsulating peritonitis OR abdominal cocoon OR frozen abdomen OR ascites
#2	endometriosis OR endometrioma OR endometriotic OR hemosiderophage
Final search	#1 AND #2

	Treatment for ascites	Outcome
Dun et al, 2016²⁹29 Dun EC, Wong S, Lakhi NA, Nehzat CH. Recurrent massive ascites due to mossy endometriosis. Fertil Steril 2016;106(06):e14. Doi: 10.1016/j.fertnstert.2016.07.1119 https://doi.org/10.1016/j.fertnstert.201...	Leuprolide + oral norethindrone	Ascites persisted
	Laparoscopic evacuation of ascites and excision of endometriosis	No recurrence (6-month follow-up)
Hasdemir et al, 2015⁴⁰40 Hasdemir PS, Ikiz N, Ozcakir HT, Kara E, Guvenal T. Endometriosis associated with relapsing ascites and pleural effusions. J Obstet Gynaecol 2015;35(04):419. Doi: 10.3109/01443615.2014.948823 https://doi.org/10.3109/01443615.2014.94...	Leuprorelin acetate for 6 months	Resolution of symptoms until 2 months after cessation
	Dienogest	Resolution of symptoms (3-month follow-up)
Hinduja et al, 2016⁴²42 Hinduja I, Kapadia K, Udwadia F, Bhilawadikar R, Adhe A, Zaveri K. Unusual presentation of endometriosis with haemorrhagic ascites - A case report. J Obstet Gynaecol 2016;36(01):133-134. Doi: 10.3109/01443615.2015.1030605 https://doi.org/10.3109/01443615.2015.10...	Leuprolide 3.75 mg monthly	Recurrence after 6 months
	TAH + BSO	Ascitic fluid leakage through vaginal suture line (10 days after the operation)
	Short-acting GnRH agonist + oral danazol followed by GnRH only	No recurrence (1-year follow-up)
Setubal et al, 2015²⁴24 Setubal A, Sidiropoulou Z, Soares S, Barbosa C. Endometriosis and ascites: a strategy to achieve pregnancy. J Minim Invasive Gynecol 2015;22(06):1104-1108. Doi: 10.1016/j.jmig.2015.05.013 https://doi.org/10.1016/j.jmig.2015.05.0...	Continuous OCP for 3 months	Ascites persisted
	GnRH agonist, then laparoscopic excision of lesions followed by GnRH agonist	Minimal ascites
	Underwent IVF protocol	Minimal ascites
	OCP	Symptom-free
Appleby et al, 2014²⁸28 Appleby R, Saroya H, Postgate A, Meer Z. A young woman with abdominal distension. BMJ Case Rep 2014;2014:bcr2014203726. Doi: 10.1136/bcr-2014-203726 https://doi.org/10.1136/bcr-2014-203726...	GnRH antagonist	No recurrence (6-month follow-up)
Asano et al, 2014³⁰30 Asano R, Nakazawa T, Hirahara F, Sakakibara H. Dienogest was effective in treating hemorrhagic ascites caused by endometriosis: a case report. J Minim Invasive Gynecol 2014;21(06):1110-1112. Doi: 10.1016/j.jmig.2014.04.014 https://doi.org/10.1016/j.jmig.2014.04.0...	GnRH agonist	Ascites recurred
	Oral dienogest	No recurrence (1-year follow-up)
Bignall et al, 2014²²22 Bignall J, Arambage K, Vimplis S. Endometriosis: a rare and interesting cause of recurrent haemorrhagic ascites. BMJ Case Rep 2014;2014:bcr2013010052. Doi: 10.1136/bcr-2013-010052 https://doi.org/10.1136/bcr-2013-010052...	GnRH agonists	Ascites recurred
	GnRH agonists + tibolone + NSAIDs + pregabalin	Symptoms well-controlled
Cosma et al, 2014⁴¹41 Cosma S, Ceccaroni M, Benedetto C. A pseudoneoplastic finding of deep endometriosis: laparoscopic triple segmental bowel resection. Wideochir Inne Tech Malo Inwazyjne 2014;9(03):463-467. Doi: 10.5114/wiitm.2014.41617 https://doi.org/10.5114/wiitm.2014.41617...	Laparoscopic excision of lesions	Modest recurrence (250 mL) after 42 days
Shabeerali et al, 2012¹¹11 Shabeerali TU, Rajan R, Kuruvilla AP, et al. Hemorrhagic ascites: are we missing endometriosis? Indian J Gastroenterol 2012;31 (04):195-197. Doi: 10.1007/s12664-012-0221-1 https://doi.org/10.1007/s12664-012-0221-...	CASE 1: GnRH analogue	No recurrence (6-month follow-up)
	CASE 2: Subtotal abdominal hysterectomy + BSO	No recurrence (1-year follow-up)
	CASE 3: GnRH analogues for 1 year; then, TAH + BSO	Partial response; then, relatively asymptomatic at 1-year follow-up
Ferrero and Remorgida, 2011³⁶36 Ferrero S, Remorgida V. Endometriosis presenting with hemorrhagic ascites. Arch Gynecol Obstet 2011;283(06):1429-1430. Doi: 10.1007/s00404-010-1796-3 https://doi.org/10.1007/s00404-010-1796-...	Norethindrone acetate (25 mg daily)	No recurrence (1-year follow-up)
Ignacio et al, 2010¹⁸18 Ignacio MM, Joseph N, Hélder F, Mamourou K, Arnaud W. Massive ascites, pleural effusion, and diaphragmatic implants in a patient with endometriosis. Eur J Obstet Gynecol Reprod Biol 2010;149 (01):117-118. Doi: 10.1016/j.ejogrb.2009.10.017 https://doi.org/10.1016/j.ejogrb.2009.10...	GnRH analogue	No recurrence (8-month follow-up)
Lin et al, 2010³⁷37 Lin JN, Lin HL, Huang CK, et al. Endometriosis presenting as bloody ascites and shock. J Emerg Med 2010;38(01):30-32. Doi: 10.1016/j.jemermed.2008.03.031 https://doi.org/10.1016/j.jemermed.2008....	Laparoscopic electrocauterization of lesions	Condition stabilized
Suchetha et al, 2010⁷7 Suchetha S, Rema P, Mathew AP, Sebastian P. Endometriosis with massive hemorrhagic ascites. Indian J Cancer 2010;47(02): 224-225. Doi: 10.4103/0019-509X.63004 https://doi.org/10.4103/0019-509X.63004...	GnRH analogues for 1 year	Good response
Park et al, 2009³⁹39 Park BJ, Kim TE, Kim YW. Massive peritoneal fluid and markedly elevated serum CA125 and CA19-9 levels associated with an ovarian endometrioma. J Obstet Gynaecol Res 2009;35(05): 935-939. Doi: 10.1111/j.1447-0756.2009.01122.x https://doi.org/10.1111/j.1447-0756.2009...	Laparoscopic excision of endometrioma + GnRH agonist for 6 months + tibolone	No recurrence (1-year follow-up)
Sait, 2008³⁸38 Sait KH. Massive ascites as a presentation in a young woman with endometriosis: a case report. Fertil Steril 2008;90(05):2015.e17-2015.e19	Bilateral ovarian cystectomies + GnRH analogue for 6 months followed by OCP	No recurrence (2-year follow-up)
Santos et al, 2007⁶6 Santos VM, Barbosa ER Jr, Lima SH, Porto AS. Abdominal cocoon associated with endometriosis. Singapore Med J 2007;48(09): e240-e242	Laparoscopy + laparotomy	NR. Patient died after 5 months
Palayekar et al, 2007²⁰20 Palayekar M, Jenci J, Carlson JA Jr. Recurrent hemorrhagic ascites: a rare presentation of endometriosis. Obstet Gynecol 2007;110(2 Pt 2):521-522	TAH + BSO	No recurrence (1-year follow-up)
Fortier et al, 2005²³23 Fortier D, Dedecker F, Gabriele M, Graesslin O, Barau G.[Endometriosis with ascites and pleural effusion: a case report]. Gynecol Obstet Fertil 2005;33(7-8):508-510. Doi: 10.1016/j.gyobfe.2005.05.014 https://doi.org/10.1016/j.gyobfe.2005.05...	Ovarian cystectomy + GnRH analogue for 6 months + laparoscopic excision of lesions + oral progesterone for 6 months	Two recurrences
	Ceased treatment and started clomiphene due to pregnancy desire	Ascites recurrence
	GnRH for 2 months	Ascites recurrence
	GnRH for 6 months	Ascites recurrence
Mohd Noor et al, 2004⁸8 Mohd Noor NH, Zaki NM, Kaur G, Naik VR, Zakaria AZ. Abdominal cocoon in association with adenomyosis and leiomyomata of the uterus and endometriotic cyst : unusual presentation. Malays J Med Sci 2004;11(01):81-85	Laparotomy + excision of lesions	No recurrence (4-week follow-up)
Zeppa et al, 2004³⁵35 Zeppa P, Vetrani A, Cozzolino I, Palombini L. Endometrial glands in ascites secondary to endometriosis. Diagn Cytopathol 2004;30 (02):131-132. Doi: 10.1002/dc.10390 https://doi.org/10.1002/dc.10390...	NR	NR
Cheong and Lim, 2003³3 Cheong EC, Lim DT. Massive ascites-an uncommon presentation of endometriosis. Singapore Med J 2003;44(02):98-100	NR	NR
Jeanes et al, 2002³⁴34 Jeanes AC, Murray D, Davidson B, Hamilton M, Watkinson AF. Case report: hepatic and retro-peritoneal endometriosis presenting as obstructive jaundice with ascites: a case report and review of the literature. Clin Radiol 2002;57(03):226-229. Doi: 10.1053/crad.2001.0667 https://doi.org/10.1053/crad.2001.0667...	Double hysterectomy + left oophorectomy followed by estradiol for 6 months followed by goserelin	No recurrence (3-year follow-up)
Moffatt and Mitchell, 2002¹⁹19 Moffatt SD, Mitchell JD. Massive pleural endometriosis. Eur J Cardiothorac Surg 2002;22(02):321-323. Doi: 10.1016/S10107940(02)00277-4 https://doi.org/10.1016/S10107940(02)002...	Leuprolide + premarin	Recurrence after 4 weeks
	TAH + BSO + leuprolide	No recurrence (9-month follow-up)
Bhojawala et al, 2000¹⁷17 Bhojawala J, Heller DS, Cracchiolo B, Sama J. Endometriosis presenting as bloody pleural effusion and ascites-report of a case and review of the literature. Arch Gynecol Obstet 2000; 264(01):39-41. Doi: 10.1007/PL00007484 https://doi.org/10.1007/PL00007484...	TAH + RSO	No recurrence (6-week follow-up)
Samora-Mata and Feste, 1999²⁵25 Samora-Mata J, Feste JR. Endometriosis ascites: a case report. JSLS 1999;3(03):229-231	TAH + RSO	NR
Myneyyirci-Delale et al, 1998¹²12 Muneyyirci-Delale O, Neil G, Serur E, Gordon D, Maiman M, Sedlis A. Endometriosis with massive ascites. Gynecol Oncol 1998;69 (01):42-46. Doi: 10.1006/gyno.1998.4953 https://doi.org/10.1006/gyno.1998.4953...	Laparoscopic excision of lesions followed by GnRH agonist for 6 months; then, excision of new ovarian cyst + danazol daily for 6 months followed by norethindrone acetate	Recurrence after 1 year; then, no recurrence (3-year follow-up)
	Laparotomy + monthly depo provera injections; then, TAH + BSO	Recurrence after 3 years; then, no recurrence (6-month follow-up)
	Appendectomy and left ovarian wedge resection + lupron	No recurrence
	Lysis of adhesions + LSO followed by lupron followed by norethindrone acetate	NR
Frigerio et al, 1997⁵5 Frigerio L, Taccagni GL, Mariani A, Mangili G, Ferrari A. Idiopathic sclerosing peritonitis associated with florid mesothelial hyperplasia, ovarian fibromatosis, and endometriosis: a new disorder of abdominal mass. Am J Obstet Gynecol 1997;176(03):721-722. Doi: 10.1016/S0002-9378(97)70581-7 https://doi.org/10.1016/S0002-9378(97)70...	TAH + BSO + appendectomy + omentectomy	No recurrence (3-year follow-up)
Mejia et al, 1997¹⁶16 Mejia EM, Alvarez OA, Lee M. Endometriosis with massive bloody ascites. J Am Board Fam Pract 1997;10(01):59-61	Laparotomy	No recurrence (15-month follow-up)
Flanagan and Barnes, 1996²¹21 Flanagan KL, Barnes NC. Pleural fluid accumulation due to intraabdominal endometriosis: a case report and review of the literature.Thorax1996;51(10):1062-1063.Doi:10.1136/thx.51.10.1062 https://doi.org/10.1136/thx.51.10.1062...	Laparotomy + GnRH agonist for 6 months	Recurrence (twice in 1 year)
	Prednisolone 30 mg daily	Recurrence
	Leuprorelin for 5 months	Recurrence
Myers et al, 1995³³33 Myers TJ, Arena B, Granai CO. Pelvic endometriosis mimicking advanced ovarian cancer: presentation with pleural effusion, ascites, and elevated serum CA 125 level. Am J Obstet Gynecol 1995;173(3 Pt 1):966-967	TAH + BSO + lysis of adhesions	No recurrence (8-month follow-up)
Jose et al, 1994³²32 Jose R, George SS, Seshadri L. Massive ascites associated with endometriosis. Int J Gynaecol Obstet 1994;44(03):287-288. Doi: 10.1016/0020-7292(94)90185-6 https://doi.org/10.1016/0020-7292(94)901...	LSO	Recurrence after 1 year
	Laparotomy + danazol	NR
Schlueter an McClennan, 1994¹³13 Schlueter FJ, McClennan BL. Massive ascites and pleural effusions associated with endometriosis. Abdom Imaging 1994;19(05): 475-476	Leuprolide acetate monthly	No recurrence (3-month follow-up)
Williams and Wagaman, 1991¹⁵15 Williams RS, Wagaman R. Endometriosis associated with massive ascites and absence of pelvic peritoneum. Am J Obstet Gynecol 1991;164(1 Pt 1):45-46. Doi: 10.1016/0002-9378(91)90621-W https://doi.org/10.1016/0002-9378(91)906...	Medroxyprogesterone acetate	Recurrence after 1 month
	Depot lupron for 3 months	Some ascites
	TAH + BSO	Recurrence after 3 months
	Tenckhoff catheter placed for 2 weeks	No recurrence (9-month follow-up)
Chichareon and Wattanakitkrailert, 1988³¹31 Chichareon SB, Wattanakitkrailert S. Endometriosis with ascites. Acta Obstet Gynecol Scand 1988;67(02):187-188. Doi: 10.3109/00016348809004198 https://doi.org/10.3109/0001634880900419...	TAH + BSO	No recurrence (6-month follow-up)
Olubuyide et al, 1988²⁷27 Olubuyide IO, Adebajo AO, Adeleye JA, Solanke TF. Massive ascites associated with endometriosis in a Nigerian African. Int J Gynaecol Obstet 1988;27(03):439-441. Doi: 10.1016/0020-7292(88) 90127-0 https://doi.org/10.1016/0020-7292(88)...	Oral norethisterone	No recurrence (1-year follow-up)
Naraynsingh et al, 1985²⁶26 Naraynsingh V, Raju GC, Ratan P, Wong J. Massive ascites due to omental endometriosis. Postgrad Med J 1985;61(716):539-540. Doi: 10.1136/pgmj.61.716.53 https://doi.org/10.1136/pgmj.61.716.53...	Depo provera for 6 months	No recurrence (4-year follow-up)
Cantor et al, 1979¹⁴14 Cantor JO, Fenoglio CM, Richart RM. A case ofextensive abdominal endometriosis. Am J Obstet Gynecol 1979;134(07):846-847. Doi: 10.1016/0002-9378(79)90958-X https://doi.org/10.1016/0002-9378(79)909...	NR	NR

[1] Address for correspondence Thais Fontes de Magalhães, MD, Departmento de Ginecologia, Universidade Federal do Ceara, Rua Alexandre Barauna 949, Fortaleza, CE, 60430-160, Brazil (e-mail: thaisfdemagalhaes@gmail.com).

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Ascites and Encapsulating Peritonitis in Endometriosis: a Systematic Review with a Case Report

Endometriose com ascite e peritonite encapsulante: uma revisão sistemática com descrição de um caso clínico

Abstract