LAPAROSCOPIC VAPORIZATION OF DIAPHRAGMATIC ENDOMETRIOSIS IN A WOMAN WITH EPIGASTRIC PAIN - A CASE-REPORT

BACKGROUND: Endometriosis has been observed in 8-15% of reproductive a ge women and is commonly found in pelvic and nonpelvic organs. Despite its widespread prevalence, the etiology remains obscure. CASE: A 22-y ear-old woman with intractable epigastric and pelvic pain who was trea ted previously by laser ablation for pelvic and diaphragmatic endometr iosis was referred to our clinic. The patient received leuprolide acet ate for six months, but the symptoms did not improve. Second-look lapa roscopy revealed deep endometriotic spots involving both the diaphragm s, exactly in the line of the left ventricle. With visualization, endo metriosis was excised in total with the help of hydrodissection and CO 2 vaporization. CONCLUSION: As in pelvic endometriosis, therapy for ex trapelvic endometriosis consists of surgical and hormonal manipulation following the diagnosis. The importance of extreme caution, meticulou s surgery and cardiothoracic consultation when treating the diaphragma tic surface cannot be overemphasized.