Recurrent Haemorhagic Ascites - A Rare Presentation of Endometriosis

Background: Endometriosis is defined as the presence of endometrial glands and stroma outside the uterus. Recurrent hemorrhagic ascites as a clinical manifestation of endometriosis is rare. On the other hand endometriosis as a cause of ascites is not considered in current practice. We report the case of a 25 year old woman who presents recurrent hemorrhagic ascites with endometriosis. Case summary: A 25 year old para nil Bangladeshi woman suddenly developed huge ascites with abdominal pain. Ascitic fluid was reddish in color with plenty of RBC. The Initial diagnosis was considered as TB. But as symptom did not subside after administration of anti-TB drug further investigations was carried out including laparoscopy. The diagnosis was established by histology proven endometriosis, exclusion of other causes and treatment response. Conclusion: This case requires long-term follow-up with continuing medical management at least until the patient's family is complete when a surgical option as bilateral salpingo-oophorectomy with or without hysterectomy can be discussed.