Endometriosis-related spontaneous hemoperitoneum in the early second trimester: A case report |
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Authors: | Lan-Yin Huang Pei-Yang Hsu Chun-Ting Chiang Hui-Wen Chen Meng-Hsing Wu |
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Affiliation: | 1. Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;2. Chang Fertility Clinic, Kaohsiung, Taiwan;3. Department of Pathology, Chiayi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan;4. Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan |
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Abstract: | ObjectiveTo present a rare case of endometriosis-related spontaneous hemoperitoneum in pregnancy (SHiP) with atypical subacute symptoms, which is likely to be mistaken as an infectious disease initially.Case reportA 35-year-old primigravid woman presented with diffuse lower abdominal pain and signs of peritoneal irritation for five days at 18 weeks’ gestation, and the initial diagnosis was acute peritonitis. An abrupt deterioration with maternal shock and stillbirth of fetus was found in spite of close observation in emergent department. Emergent laparotomy was performed for delay-appeared hemoperitoneum. Bleeding from decidualized endometriotic tissue over posterior uterine surface was found, and hemostasis was achieved with uterine preservation. The patient recovered smoothly.ConclusionSHiP is a serious obstetric complication of endometriosis with diagnostic difficulty. Its initial presentation may mimic infectious disease, so close monitoring for possible abrupt deterioration is crucial. Early detection and timely management are the key to avoid adverse pregnancy outcomes. |
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Keywords: | Endometriosis Hemoperitoneum Pregnancy complications |
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