Laparoscopic Management of Phrenic Endometriosis

Abstract

Introduction

Extrapelvic endometriosis is a rare condition typically associated with variable symptomatology and complex diagnosis.

Case report: Here, we report a rare case of phrenic endometriosis manifested insidiously in a woman of reproductive age after a prolonged history of endometriosis with several surgical interventions, including laparoscopic bowel resection a few months ago. The patient presented with menstrual-related, cyclical, right upper abdominal pain.

Results

Accurate surgical inspection during the laparoscopic procedure enabled the identification and full resection of a deep infiltrating endometriotic lesion growing from the peritoneum into the phrenic tissue, which was suspected by symptomatology. No pulmonary complications were detected before or after surgery except for a small right-sided pneumothorax, which did not require drainage and disappeared spontaneously after five days.

Conclusions

The rare case reported here emphasizes the importance of a very exact conversation with the patient before surgery, a systematic and accurate surgical exploration for the diagnosis, and the successful laparoscopic treatment of a symptomatic phrenic disease in a woman with a longstanding history of endometriosis.