ABSTRACT
An increased incidence of benign hepatic adenoma among users of oral contraceptives has been reported by several investigators during the past ten years. The majority of patients present with right-upper-quadrant pain, often associated with an upper abdominal mass. Our patient had an unusual clinical presentation simulating pelvic inflammatory disease. The appropriate diagnosis was reached with the aid of pelvic and abdominal sonography, liver-spleen scan and culdocentesis. The definitive management is partial hepatectomy, although there are reports of complete regression without surgery in minimally symptomatic patients following cessation of oral contraceptives.
Subject(s)
Carcinoma, Hepatocellular/chemically induced , Contraceptives, Oral, Hormonal/adverse effects , Contraceptives, Oral/adverse effects , Liver Neoplasms/chemically induced , Pelvic Inflammatory Disease/diagnosis , Adult , Carcinoma, Hepatocellular/diagnosis , Diagnosis, Differential , Female , Humans , Liver Neoplasms/diagnosisABSTRACT
Endometriosis associated with massive ascites is an unusual combination unknown to most practicing gynecologists. Only 11 cases have been reported since this entity was first described by Brews in 1954. The authors report an additional case recently encountered at the Bethesda Naval Hospital. A review of the literature and tabular comparison of similarities among patients are presented. The possible etiologic mechanisms of the ascites are explored and recommendations for diagnosis and appropriate management are provided.
