Abstract
Objective To review the clinical presentations of and management options for diaphragmatic endometriosis.
Design Retrospective review.
Setting Referral center.
PATIENT(S): Twenty-four women with endometriosis of the diaphragm.
INTERVENTION(S): Surgical management.
MAIN OUTCOME MEASURE(S): Diagnostic accuracy and therapeutic feasibility of operative laparoscopy.
RESULT(S): Operative findings in 17 patients included 2-5 spots of endometriosis on the diaphragm measuring <1 cm. Seven women had numerous lesions scattered across the diaphragm. Lesions were bilateral in 8 patients, limited to the right hemidiaphragm in 14 patients, and limited to the left hemidiaphragm in 2 patients. In 7 patients, six endometriosis lesions were directly in the line of the left ventricle and three lesions were adjacent to the phrenic nerve. Endometriosis was infiltrating into the muscular layer of the diaphragm in 7 patients. The symptoms in all 7 symptomatic patients decreased significantly after treatment, with a minimum follow-up period of 12 months. No postoperative complications occurred.
CONCLUSION(S): The abdominal diaphragm can be involved with endometriosis and can be diagnosed and treated effectively with the use of videolaparoscopy.
diaphragmatic endometriosis laparoscopic surgical management, Nezhat diaphragm endometriosis videolaparoscopy treatment, endometriosis diaphragm operative laparoscopy excision, extrapelvic endometriosis diaphragm right hemidiaphragm, diaphragmatic endometriosis phrenic nerve involvement, thoracic endometriosis surgical treatment outcomes, deep infiltrating endometriosis muscular layer diaphragm, laparoscopic ablation diaphragm endometriosis referral center, endometriosis bilateral diaphragm lesions symptom resolution, rare locations endometriosis laparoscopic diagnosis treatment
PMID 9627291 9627291 DOI 10.1016/s0015-0282(98)00056-9 10.1016/s0015-0282(98)00056-9
Keywords
Adolescent, Adult, Diaphragm/diagnostic Imaging/pathology/surgery, Endometriosis/diagnostic Imaging/pathology/surgery, Feasibility Studies, Female, Humans, Laparoscopy, Muscular Diseases/diagnostic Imaging/pathology/surgery, Retrospective Studies, Ultrasonography