A RARE CASE OF OMENTAL ENDOMETRIOSIS ASSOCIATED WITH OVARIAN FIBROMA AND HEMORRHAGIC ASCITES: IMAGING INSIGHTS

Abstract

A case of omental endometriosis with recurrent haemorrhagic ascites in a 22 year old nullipara is presented. She first presented at a private hospital with a three month history of progressive abdominal distention and the transabdominal ultrasound scan revealed a right ovarian mass with massive ascites. She had laparotomy and the histology reports of the omental and ovarian samples revealed endometriosis and fibroma respectively. She presented to us with a recurrence of the distension six months later. Repeat transabdominal ultrasound scan and an abdominopelvic computed tomograhpy revealed only a massive ascites. She had a second laparotomy and the histology of the degenerating omental sample still revealed endometriosis. Patient was managed satisfactorily on hormonal therapy without recurrence over a two year follow up. The Literature on the appropriate imaging modalities in endometriosis is reviewed and these showed that with judicious use, imaging is accurate in the pre-operative diagnosis.