A. Witte et O. Guilbaud, ENDOMETRIOSIS OF THE DIAPHRAGM - DIAGNOST IC FEATURES OF A CASE WITHOUT PNEUMOTHORAX, La Revue de medecine interne, 16(7), 1995, pp. 527-532
Diaphragmatic disease is a rare manifestation of endometriosis. In the
literature it is most often revealed by catamenial pneumothorax. We d
escribe the case of a 21-year old woman presenting with tight-sided ph
renic neuralgia, lasting 18 months. Signs of pelvic endometriosis appe
aring later on, laparoscopy showing thin lesions of endometriosis on t
he diaphragmatic undersurface. We review the few similar cases describ
ed earlier. They confirm that imaging studies are of little value, the
diagnosis being made only after the discovery of pelvis disease. Our
study of the multiple causes of phrenic neuralgia allows to establish
criteria indicating when laparoscopy is warranted. Increasing practice
of this test will shed light on the natural history of diaphragmatic
endometriosis.