Re: endometriosis?

From: Richard Kaplan (rkaplan@triad.rr.com)
Fri Feb 1 20:25:16 2008


Thank you all for your replies. I have found some other good articles using "Thoracic Endometriosis Syndrome" as the search entity. I was thinking along the same line as Dr. Joe about doing the diagnostic study (MR or CT) during the menses in the hope that a small pleural lesion will be more visible at that time. I will let you know what I find. I would also like to give you some follow up on a case I posted about 3 years ago (time really flies). This was a case of a G4P3003 who presented at 22 weeks in her first pregnancy with painless cervical dilatation to 3 cm with bulging membranes. I placed a rescue cerclage and she carried to term. After placing 2 more prophylactic cerclages in her next 2 pregnancies (which she carried well past the date I removed them), I asked the list if they thought I was taking too great a risk in simply following her 4th pregnancy with ultrasound measurement of the cervix and not placing another cerclage. After sharing some of your opinions with the patient we chose not to place the cerclage and she not only carried that pregnancy to term but she is now in her 39th week with boy number 5.

--
Richard Kaplan

> ----- Original Message ----- From: Terrence.Jones@kp.org To: Multiple recipients of list OB-GYN-L Sent: Friday, February 01, 2008 9:14 PM Subject: Re: endometriosis?

Richard, if endometriosis, and causing pulmonary sxs, condition is referred to as TES: Thoracic Endometriosis Syndrome. It has come up on the list in the past. First in late 90's - not sure if that's even available in the archives. But more recently in 7/22/2001 - look under "Re: pulmonary endometriosis". Prior to that was 10/26/04: "Re: catamenial hemoptysis". To save the historical evolution process, go directly to Alifano, Amer Jnl Respir Crit Care Med (11/07), 176:1048-53. For presentation of CT changes over time, see Liu, Int Jnl Clin Pract (2/06) 60:232-3. Remember the phrenic nerve, and think diaphragmatic stoma. If TES (Thoracic Endometriosis Syndrome), consider VATS (video assisted thorascopic surgery) and count blessings symptoms are right sided. /tj

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"Richard D. Kaplan" <rkaplan@triad.rr.com> Sent by: ob-gyn-l@obgyn.net 02/01/2008 14:12 Please respond to ob-gyn-l@obgyn.net

To Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net> cc Subject endometriosis?

37 y.o black female G1P0010(ectopic age 27) presents to office with 3 months of persistent and sever pain in the subclavicular area on the right chest area. Pain is worse with deep inspiration and only occurs with menses. She has not been on hormonal contraceptives. Have any of you seen pleuritic endometriosis? Does anyone think a CT of the chest would help define her problem?

Richard Kaplan, OBG





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