Case Report: PDF OnlyEndometriosis Associated with HemothoraxLee, Hung-Tsunga; Wang, Hong-Chunga, *; Huang, Ia-Tanga; Chang, Huang-Choub; Lu, Jau-YeongcAuthor Information aDivision of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C. bDivision of Thoracic Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C. cDivision of Chest MedicineDepartment of Internal Medicine, E-DA Hospital, Kaohsiung, Taiwan, R.O.C. *Correspondence to: Dr. Hong-Chung Wang, Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan, R.O.C. E-mail: [email protected] Received: January 3, 2005; • Accepted: August 10, 2005. Journal of the Chinese Medical Association: January 2006 - Volume 69 - Issue 1 - p 42-46 doi: 10.1016/S1726-4901(09)70110-8 Metrics Abstract Bloody pleural effusion is rarely associated with endometriosis. To effectively treat this condition, it is important to differentiate the malady from other common diseases such as malignancy or tuberculosis. We describe the case of a 40-year-old multiparous female featuring right-sided hemothorax presenting with right shoulder pain and progressive shortness of breath for the preceding 2 months. Thoracoscopy disclosed grossly negative findings apart from multiple small pores in the right hemi-diaphragm with blood clots within them. Examination of the thoracoscopic biopsy specimens showed chronic pleuritis without evidence of malignancy or tuberculosis. Pelvic endometriosis was considered a possible diagnosis according to the results of abdominal computed tomography (CT) scan, transvaginal sonography, and the results of dilatation and curettage. Periodic episodes of symptoms concurrent with menstruation led to the suspicion of a relationship between these conditions in our patient. Despite the patient undergoing an abdominal total hysterectomy and adhesiolysis without salpingo-oophorectomy, recurrent right-sided bloody pleural effusion developed 1.5 months subsequent to surgery. As a consequence, danazol (400 mg/day) was maintained because of the endometriosis associated with pleural effusion. One year of regular follow-up later, there was no evidence of recurrent pleural effusion. We considered that the bloody pleural fluid arose via seepage from the pelvic endometriosis through the pores of the right hemi-diaphragm during menstruation. © 2006 by Lippincott Williams & Wilkins, Inc.