Hemorrhagic Ascites in a Young Nulliparous Patient - A Very Rare Endometriosis-Related Complication

Hemorrhagic ascites is an exceptional complication of endometriosis, rarely reported in the literature. Since the description of the first case in 1954, by Brews, no more than 60 cases of endometriosis associated with hemorrhagic ascites have been reported in the literature. It mostly affects nulliparous women of childbearing age. The diagnosis remains difficult because of the variety and non-specificity of its symptoms. We report a case of a 22 years old nulliparous woman with hemorrhagic ascites and peritoneal endometriosis diagnosed by laparoscopy. After surgery the patient received 6 months of oestro-progestative hormonal therapy. With this treatment she remained asymptomatic. After one year without hormonal therapy, the ascites recurred spontaneously.